JP2019513060A - Circular stapling system including rotary firing system - Google Patents

Abstract

An end effector for use with a surgical stapler is disclosed. The end effector includes a cartridge body having a longitudinal axis, and a plurality of staple cavities defined in the cartridge body. The staple cavities include a first staple cavity annular array extending around the longitudinal axis and a second staple cavity annular array extending around the longitudinal axis. The end effector further includes a staple releasably stored within the staple cavity, and a ramped surface rotatable about a longitudinal axis to continuously eject the staples from the staple cavity.

Description

  The present invention relates to surgical instruments and, in various situations, to surgical stapling and severing instruments and staple cartridges for use therewith, designed to staple and cut tissue.

Various features of the embodiments described herein, as well as their advantages, can be understood by the following description in conjunction with the accompanying drawings in which:
FIG. 10 is a perspective view of a surgical instrument with a replaceable surgical tool assembly according to at least one embodiment. FIG. 7 is another perspective view of the handle assembly of the surgical instrument of FIG. 1 with a portion of the handle housing omitted to expose internally stored components. FIG. 4 is an exploded view of a portion of the handle assembly of the surgical instrument of FIGS. 1 and 2; FIG. 5 is a cross-sectional perspective view of the handle assembly of FIGS. 2 and 3; FIG. 5 is a partial cross-sectional side view of the handle assembly of FIGS. 2 to 4 wherein the grip portion of the handle assembly in position relative to the main housing portion of the handle assembly is shown in solid lines and in another position relative to the main housing portion The grips at are shown in phantom. 6 is an end cross-sectional view of the handle assembly of FIGS. 2-5, taken along line 6-6 in FIG. 5; 7 is another end cross-sectional view of the handle assembly of FIGS. 2-6, taken along line 7-7 in FIG. 5; FIG. 8 is another end cross-sectional view of the handle assembly of FIGS. 2-7, showing the shifter gear in meshing engagement with the drive gear on the rotational drive socket; FIG. 10 is another end cross-sectional view of the handle assembly of FIGS. 2-8, showing the position of the shifter solenoid when the shifter gear is in meshing engagement with the drive gear on the rotational drive socket; FIG. 10 is another perspective view of the handle assembly of FIGS. 2-9, with certain portions of the handle assembly shown in cross section and the access panel portion of the handle assembly shown in phantom lines. FIG. 12 is a plan view of the handle assembly of FIGS. 2-11, with the bailout system shown in an operable position. FIG. 12 is a perspective view of the extraction handle of the extraction system shown in FIGS. FIG. 13 is an exploded view of a portion of the escape handle of FIG. 12 with a portion of the escape handle shown in cross section. FIG. 12 is a cross-sectional elevation view of the handle assembly of FIG. FIG. 1 is an exploded view of a replaceable tool assembly according to at least one embodiment. FIG. 16 is a perspective view of the replaceable tool assembly of FIG. 15; FIG. 16 is a cross-sectional perspective view of the interchangeable tool assembly of FIG. 15; FIG. 16 is an exploded cross-sectional view of the interchangeable tool assembly of FIG. 15; FIG. 16 is a perspective view of an articulation block of the interchangeable tool assembly of FIG. 15; FIG. 20 is a cross-sectional perspective view of an articulation joint of the interchangeable tool assembly of FIG. 15 including the articulation block of FIG. 19; FIG. 21 is another cross-sectional perspective view of the articulation joint of FIG. 20; FIG. 16 is a partially exploded view of the replaceable tool assembly of FIG. 15; FIG. 16 is another partially exploded view of the replaceable tool assembly of FIG. 15; FIG. 21 is a partially exploded view of the articulation joint of FIG. 20. FIG. 16 is a cross-sectional perspective view of the proximal end of the interchangeable tool assembly of FIG. 15; FIG. 16 is an end view of the interchangeable tool assembly of FIG. 15; FIG. 27 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 taken along line 27-27 in FIG. 26 illustrating the clamped but unfired end effector; FIG. 28 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 taken along line 28-28 in FIG. 26 illustrating the clamped but unfired end effector. FIG. 29 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15, taken along line 29-29 in FIG. 26, illustrating the end effector in a clamped but unfired state; FIG. 16 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 shown in a disassembled state. 16 is an end effector of the interchangeable tool assembly of FIG. 15 articulated in a first direction. 16 is an end effector of the interchangeable tool assembly of FIG. 15 articulated in a second direction. FIG. 16 is a perspective view of the cartridge body of the replaceable tool assembly of FIG. 15; FIG. 18 is a perspective view of a cartridge body in accordance with at least one alternative embodiment. FIG. 18 is an exploded view of the end effector of the replaceable tool assembly according to at least one alternative embodiment. FIG. 36 is an exploded view of the end effector of FIG. 35; FIG. 18 is an exploded view of the end effector of the interchangeable tool assembly according to at least one alternative embodiment. FIG. 18 is an exploded view of the end effector of the interchangeable tool assembly according to at least one alternative embodiment. FIG. 10 is a perspective view illustrating a staple cartridge and shaft of a surgical stapling instrument according to at least one embodiment. FIG. 40 is a partial cross-sectional view of a staple cartridge assembled to the stapling instrument of FIG. 39; A portion of a surgical stapling instrument including a closure drive, an anvil, and a lockout configured to prevent the anvil from being assembled to the closure drive when the closure drive is not in a fully extended position. FIG. FIG. 42 is a partial cross-sectional view of the surgical stapling instrument of FIG. 41 illustrating the anvil attached to the closure drive; FIG. 10 is a partial perspective view of a surgical stapling instrument including a staple cartridge and a closure drive configured to move the anvil relative to the staple cartridge. FIG. 44 is a partial cross-sectional view of the stapling instrument of FIG. 43 illustrating a lockout configured to prevent retraction of the closure drive before the anvil is attached to the closure drive; FIG. 45 is a partial cross-sectional view of the stapling instrument of FIG. 44 illustrating the anvil attached to the closure drive and the lockout being disengaged from the closure drive; A staple cartridge including staples removably stored therein, an anvil, a closure drive configured to move the anvil relative to the staple cartridge, and a ejector configured to eject the staples from the staple cartridge And FIG. 7 is a partial cross-sectional view of a surgical stapling instrument including a drive. FIG. 17 is a detail view of the lockout configured to prevent actuation of the firing drive before the anvil moves to the closed position. FIG. 48 is a detail view of the lockout of FIG. 47 disengaged from the firing drive; A staple cartridge including staples removably stored therein, an anvil, a closure drive configured to move the anvil relative to the staple cartridge, and a ejector configured to eject the staples from the staple cartridge And FIG. 5 is a partial perspective view of a surgical stapling instrument including a drive. 49 of the lockout of the surgical stapling instrument of FIG. 49, configured to prevent actuation of the firing drive before the anvil exerts sufficient pressure on the tissue captured between the anvil and the staple cartridge; FIG. FIG. 51 is a detail view of the lockout of FIG. 50 disengaged from the firing drive; A staple cartridge including staples removably stored therein, an anvil, a closure drive configured to move the anvil relative to the staple cartridge, and a ejector configured to eject the staples from the staple cartridge And FIG. 5 is a partial perspective view of a surgical stapling instrument including a drive. 53 is a detail view of the lockout of the surgical stapling instrument of FIG. 52 configured to prevent removal of the anvil from the closure drive while the cutting member of the firing drive is exposed above the staple cartridge. It is. FIG. 54 is a detail view of the lockout of FIG. 53 disengaged from the anvil after the firing drive has been fully retracted after the firing stroke. A staple cartridge including staples removably stored therein, an anvil, a closure drive configured to move the anvil relative to the staple cartridge, and a ejector configured to eject the staples from the staple cartridge And FIG. 7 is a partial cross-sectional view of a surgical stapling instrument including a drive. FIG. 56 is a partial cross-section of the surgical stapling instrument of FIG. 55 showing the closure drive in a clamping configuration and the firing drive in a non-firing configuration, the firing drive holding the lockout in the non-releasing configuration FIG. FIG. 56 is a partial cross-sectional view of the surgical stapling instrument of FIG. 55 illustrating the firing drive at least partially in the firing configuration and the lockout of FIG. 56 in the release configuration; FIG. 55 illustrates the lockout of FIG. 56 engaged with the closure driver to prevent the closure driver from extending or opening, and the clamp driver from clamping again; FIG. 17 is a partial cross-sectional view of the surgical stapling instrument of FIG. A staple cartridge including staples removably stored therein, an anvil, a closure drive configured to move the anvil relative to the staple cartridge, and a staple being ejected from the staple cartridge, FIG. 7 is a partial cross-sectional view of a surgical stapling instrument including a firing drive shown in an invalid or lockout configuration. 59 is a cross-sectional end view of the surgical stapling instrument of FIG. 59 taken along line 59A-59A in FIG. FIG. 60 is a cross-sectional view of the surgical stapling instrument of FIG. 59 illustrating a clamping configuration in which the firing drive is enabled; 60 is a cross-sectional end view of the surgical stapling instrument of FIG. 59 taken along line 60A-60A in FIG. 60; A staple cartridge including staples removably stored therein, an anvil, a closure drive configured to move the anvil relative to the staple cartridge, and a ejector configured to eject the staples from the staple cartridge FIG. 10 is a partial cross-sectional view of a surgical stapling instrument including a drive, wherein the closure drive is shown in an unclamped configuration and the firing drive is shown in an inoperable configuration. FIG. 62 is a partial cross-sectional view of the surgical stapling instrument of FIG. 61, wherein the closure drive is shown in a clamp configuration and the firing drive is shown in an operable configuration; FIG. 62 is a perspective view of the rotatable intermediate drive member of the firing drive of the surgical instrument of FIG. 61; FIG. 62 is a partial perspective view of a rotatable firing shaft of the firing drive of the surgical instrument of FIG. 61; FIG. 65 is a front view of a spring system configured to bias the firing shaft of FIG. 64 into disengagement with the intermediate drive member of FIG. 63; FIG. 10 is an exploded view of an end effector of a surgical stapling instrument including a staple cartridge according to at least one embodiment. 66 is a partial cross-sectional view of the end effector of FIG. 66 illustrating a lockout configured to prevent the end effector from operating if the staple cartridge is not fully assembled to the stapling instrument. FIG. 73 is a partial cross-sectional view of the end effector of FIG. 66 showing the lockout in the unlocked configuration; FIG. 10 is an exploded view of an end effector of a surgical stapling instrument including a staple cartridge according to at least one embodiment. 70 is a partial cross-sectional view of the end effector of FIG. 69 illustrating a lock configured to releasably retain a staple cartridge relative to a stapling instrument. 70 is a partial cross-sectional view of the end effector of FIG. 69 showing the lock in the unlocked configuration; Fig. 7 is a shaft of a surgical stapling instrument configured for use with a staple cartridge selected from a plurality of circular staple cartridges. FIG. 73 is a cross-sectional view of the distal end of the stapling instrument of FIG. 72; A surgical stapling instrument comprising: an unfired staple cartridge; and a lockout system configured to prevent the staple cartridge from being fired again after being previously fired by the firing drive of the surgical instrument. FIG. FIG. 75 is a partial cross-sectional view of the stapling instrument of FIG. 74 shown in a clamping configuration and with the firing drive in the firing configuration; FIG. 75 is a partial cross-sectional view of the stapling instrument of FIG. 74 shown in an unclamped configuration and with the firing drive in a retracted configuration; FIG. 74 is an end view of the firing drive and frame of the stapling instrument of FIG. 74 illustrating the firing drive in an unfired configuration; FIG. 75 is an end view of the firing drive and frame of the stapling instrument of FIG. 74 illustrating the firing drive in a retracted configuration; FIG. 75 is an end view of an alternative staple cartridge design that can be used with the stapling instrument of FIG. 74; FIG. 75 is an end view of an alternative staple cartridge design that can be used with the stapling instrument of FIG. 74; FIG. 1 is a perspective view of a surgical stapling instrument including a flexible shaft according to at least one embodiment. FIG. 5 is a schematic view of a surgical instrument kit including a plurality of end effectors according to at least one embodiment. FIG. 1 is a schematic view of a robotic surgical instrument system including a plurality of attachable end effectors according to at least one embodiment. FIG. 83 is a perspective view of some of the end effectors shown in FIG. 82. FIG. 5 is a perspective view of an anvil according to at least one embodiment. Figure 84 is a cross-sectional view of the anvil of Figure 84; FIG. 85 is a partial cross-sectional view of an end effector including the anvil of FIG. 84 shown in a fired configuration; FIG. 5 is a perspective view of an anvil according to at least one embodiment. FIG. 90 is a plan view of the anvil of FIG. 87. FIG. 10 is a cross-sectional view of an end effector according to at least one embodiment, shown in a clamped, unfired configuration. FIG. 90 is a cross-sectional view of the end effector of FIG. 89 shown in a launch configuration. FIG. 16 is a cross-sectional view of an end effector according to at least one alternative embodiment, shown in a clamped, unfired configuration. FIG. 91 is a cross-sectional view of the end effector of FIG. 91 shown in a launch configuration; FIG. 16 is a cross-sectional view of an end effector according to at least one alternative embodiment, shown in a clamped, unfired configuration. FIG. 91 is a cross-sectional view of the end effector of FIG. 91 shown in a launch configuration; FIG. 10 is a perspective view of a staple forming pocket according to at least one embodiment. FIG. 96 is a cross-sectional view of the staple forming pocket of FIG. 95; FIG. 7 is an exploded view of an end effector according to at least one embodiment configured to sequentially deploy a first annular staple row and a second annular staple row. FIG. 98 is a partial cross-sectional view of the end effector of FIG. 97 illustrating the firing driver deploying the staples in the first staple row; FIG. 98 is a partial cross-sectional view of the end effector of FIG. 97 illustrating the firing driver of FIG. 98 deploying staples in the second row of staples; Sequentially driving a first driver for firing the first row of staples, a second driver for firing the second row of staples, and then a third driver for driving the cutting member FIG. 10 is a partial perspective view of a firing drive configured as described above. FIG. 100 is a partial perspective view of the firing drive of FIG. 100 illustrating the first driver in the firing position; FIG. 100 is a partial perspective view of the firing drive of FIG. 100 illustrating the second driver in the firing position; FIG. 100 is a partial perspective view of the firing drive of FIG. 100 illustrating the third driver in the firing position; FIG. 100 is an exploded view of the firing drive of FIG. 100; FIG. 140 is a partial perspective view of the firing drive of FIG. 100 in the configuration of FIG. 103; FIG. 18 is an exploded view of a firing drive according to at least one alternative embodiment. FIG. 10 is a perspective view of a portion of a surgical staple cartridge for use with a circular surgical stapling instrument according to at least one embodiment. Fig. 6 is a pair of staples according to at least one embodiment of an unformed and formed configuration. FIG. 108 is a cross-sectional view of a portion of the anvil associated with the portion of the surgical staple cartridge of FIG. 107 prior to actuation of the staple forming process; FIG. 110 is another cross-sectional view of the anvil of FIG. 109 and the staple cartridge of FIG. 107 after the staples have been formed; FIG. 10 is a perspective view of a portion of a surgical staple cartridge for use with a circular surgical stapling instrument, according to at least one embodiment. FIG. 112 is a cross-sectional view of a portion of the anvil associated with the portion of the surgical staple cartridge of FIG. 111 prior to actuation of the staple formation process; FIG. 113 is another cross-sectional view of the anvil and staple cartridge of FIG. 112 after the staples have been formed. FIG. 5 is a plan view of a staple cartridge according to at least one embodiment. FIG. 10 is a bottom view of an anvil according to at least one embodiment. FIG. 10 is a cross-sectional view of a portion of an anvil associated with a portion of a surgical staple cartridge. There are three unformed surgical staples. FIG. 10 is a partial cross-sectional view of a staple cartridge of a circular stapler according to at least one embodiment. FIG. 10 is a partial perspective view of a staple cartridge of a circular stapler according to at least one embodiment.

  Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set forth herein illustrate the various embodiments of the invention in one form, and such exemplifications should be construed as limiting the scope of the invention in any manner. Absent.

The applicants of the present application own the following patent applications filed the same day as the present application, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. _________, Title of the Invention METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM ", Attorney Docket No. END 7821 USNP / 150 535,
-U.S. Patent Application No. _________, entitled "MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY", Attorney Docket No. END 7822 USNP / 150536,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD", Attorney Docket No. END 7822 USNP 1 / 150536-1,
-U.S. Patent Application No. _________, entitled "SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP PORTION", Attorney Docket No. END 7823 USNP / 150537,
-U.S. Patent Application No. _________, title of the invention "ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUALS BAILOUT SYSTEM", Attorney Docket No. END 7824 USNP / 150538,
-U.S. Patent Application No. _______, Title of the Invention SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE MEMBER ", Attorney Docket No. END7825USNP / 150539,
-U.S. Patent Application No. _________, entitled "CLOSURE SYSTEM ARRANGEMENTS FOR SURGICAL CUTTING AND STAPLING DEVICES WITH SEPARATE AND DISTINCT FIRING SHAFTS", Attorney Docket No. END7826USNP / 150540,
-U.S. Patent Application No. _________, Title of the Invention INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS ", Attorney Docket No. END 7827 USNP / 150541,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION", Attorney Docket No. END 7829 USNP / 150543,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING OF TISSUE", Attorney Docket No. END 7830 USNP / 150544,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT", Attorney Docket No. END 7831 USNP / 150545;
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT", Attorney Docket No. END7832USNP / 150546,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT", Attorney Docket No. END 7833 USNP / 150547,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT", Attorney Docket No. END 7834 USNP / 150548,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT", Attorney Docket No. END 7835 USNP / 150549,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT", Attorney Docket No. END 7836 USNP / 150 550,
-U.S. Patent Application No. _________, entitled "SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM", Attorney Docket No. END7837USNP / 150551,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS", Attorney Docket Number END 7838 USNP / 150552,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING INSTRUMENT", Attorney Docket No. END 7839 USNP / 150553,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS", Attorney Docket No. END 7840 USNP / 150 554,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET", Attorney Docket No. END7841USNP / 150555,
-U.S. Patent Application No. _________, entitled "ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS", Attorney Docket No. END7842USNP / 150556,
-U.S. Patent Application No. _________, entitled "STAPLE CARTRIDGES WITH ATRAUMATIC FEATURE", Attorney Docket No. END7843USNP / 150557,
U.S. Patent Application _________, Title of the Invention "CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT", Attorney Docket Number END7844USNP / 150558, and-U.S. Patent Application _______, Title of the Invention "CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL", Attorney Docket Number END7845 USNP 1 / 150559-1.

The applicants of this application also own the following US patent applications filed on December 31, 2015, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 984,488, entitled "MECHANISMS FOR COMPENSATING FOR BATTERY PACKURE IN POWERED SURGICAL INSTRUMENTS",
-US patent application no. 14/984, 525, title of the invention "MECHANISMS FOR COMPENSATING FOR DRIVE TRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", and-US patent application no. AND MOTOR CONTROL CIRCUITS.

The applicant of this application also owns the following US patent applications filed on February 9, 2016, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 15 / 019,220, entitled "SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR",
-U.S. Patent Application No. 15 / 019,228, entitled "SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,196, entitled "SURGICAL INSTRUMENT ATICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT",
-U.S. Patent Application No. 15 / 019,206, entitled SURGICAL INSTRUMENTS WITH AN END EFFECT EFFECTOR THAT IS HIGHLY ARTICULATTABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY ",
-U.S. Patent Application No. 15 / 019,215, entitled "SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTIFICATION ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,227, entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,235, entitled "SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN ARTICULATION SYSTEMS",
-U.S. Patent Application No. 15 / 019,230, "ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM ARRANGEMENTS",-U.S. Patent Application No. 15 / 019,245, "SURGICAL INSTRUMENTS WITH CLOSURE STROKE" REDUCTION ARRANGEMENTS ".

The applicants of this application also own the following US patent applications filed on February 12, 2016, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 15 / 043,254, entitled "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS";
-U.S. Patent Application No. 15 / 043,259, entitled "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS";
-U.S. Patent Application No. 15 / 043,275; title of the invention "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS"; FAILURE IN POWERED SURGICAL INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on June 18, 2015, each of which is incorporated herein by reference in its entirety:
US Patent Application No. 14 / 742,925, entitled "SURGICAL END EFFECTS WITH POSITIVE JAW OPENING ARRANGEMENTS",
U.S. Patent Application No. 14 / 742,941, entitled "SURGICAL END EFFECTS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES",
No. 14 / 742,914, entitled "MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 742,900, entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT",
-U.S. Patent Application No. 14 / 742,885, "DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS", and U.S. Patent Application No. 14 / 742,876, names "PUSH / PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL" INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on March 6, 2015, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 640,746, entitled "POWERED SURGICAL INSTRUMENT",
No. 14 / 640,795, entitled "MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 640,832, entitled "Adaptive TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATE FOR MULTIPLE TISSUE TYPES", Attorney Docket No. END 7557 USNP / 140482,
-U.S. Patent Application No. 14 / 640,935, entitled "OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION",
-US Patent Application No. 14 / 640,831, entitled "MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 640,859, entitled "TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES",
-U.S. Patent Application No. 14 / 640,817, entitled "INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS",
No. 14 / 640,844, entitled "CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE",
-US patent application Ser. No. 14 / 640,837, entitled "SMART SENSORS WITH LOCAL SIGNAL PROCESSING",
-U.S. Patent Application No. 14 / 640,765, entitled "SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER",
-U.S. Patent Application No. 14 / 640,799, title of the invention "SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT", and-U.S. Patent Application No. 14 / 640,780, title of the invention "SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING ".

The applicant of the present application owns the following patent applications filed on February 27, 2015, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 14 / 633,576, entitled "SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION",
-U.S. Patent Application No. 14 / 633,546, entitled "SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND",
-U.S. Patent Application No. 14 / 633,576, entitled "SURGICAL CHARGING SYSTEM THAT CHARGES AND / OR CONDITIONS ONE OR MORE BATTERIES",
-U.S. Patent Application No. 14 / 633,566, entitled "CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY",
No. 14 / 633,555, entitled "SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED",
-U.S. Patent Application No. 14 / 633,542, entitled "REINFORCED BATTERY FOR A SURGICAL INSTRUMENT",
-US patent application Ser. No. 14 / 633,548, entitled "POWER ADAPTER FOR A SURGICAL INSTRUMENT",
No. 14 / 633,526, entitled "ADAPTABLE SURGICAL INSTRUMENT HANDLE",
-U.S. Patent Application No. 14 / 633,541, title of the invention "MODULAR STAPLING ASSEMBLY", and-U.S. Patent Application No. 14 / 633,562, title of the invention "SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER ".

The applicants of the present application own the following patent applications filed on December 18, 2014, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 574,478, entitled "SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING",
No. 14 / 574,483, entitled "SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS",
-U.S. Patent Application No. 14 / 575,139, entitled "DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 575,148, entitled "LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULA TABLE SURGICAL END EFFECTORS";
No. 14 / 575,130, entitled "SURGICAL INSTRUMENT WITH ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE",
-U.S. Patent Application No. 14 / 575,143, entitled "SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS",
-U.S. Patent Application No. 14 / 575,117, entitled "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS",
-U.S. Patent Application No. 14 / 575,154, entitled "SURGICAL INSTRUMENTS WITH ARTICULA TABLE END EFFECTS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS",
-U.S. Patent Application No. 14/5744, 493, "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM", and-U.S. Patent Application No. 14/574, 500, "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION" SYSTEM ".

The applicant of the present application owns the following patent applications filed on March 1, 2013, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 13 / 782,295, entitled "Articulable Surgical Instruments With Conductive Pathways For Signal Communication", now U.S. Patent Application Publication No. 2014/0246471,
No. 13 / 782,323, entitled "Rotary Powered Articulation Joints For Surgical Instruments", now U.S. Patent Application Publication No. 2014/0246472,
No. 13 / 782,338, entitled "Thumbwheel Switch Arrangements For Surgical Instruments", now U.S. Patent Application Publication No. 2014/0249557,
No. 13 / 782,499, entitled "Electromechanical Surgical Device with Signal Relay Arrangement", now U.S. Patent Application Publication No. 2014/0246474,
-U.S. Patent Application No. 13 / 782,460, entitled "Multiple Processor Motor Control for Modular Surgical Instruments", now U.S. Patent Application Publication No. 2014/0246478,
No. 13 / 782,358, entitled "Joystick Switch Assemblies For Surgical Instruments", now U.S. Patent Application Publication No. 2014/0246477,
No. 13 / 782,481, entitled "Sensor Straightened End Effector During Removal Through Trocar", now U.S. Patent Application Publication No. 2014/0246479,
-U.S. Patent Application No. 13 / 782,518, entitled "Control Methods for Surgical Instruments with Removable Implement Portions", now U.S. Patent Application Publication No. 2014/0246475,
No. 13 / 782,375, entitled "Rotary Powered Surgical Instruments with Multiple Degrees of Freedom", now U.S. Patent Application Publication No. 2014/0246473, and-U.S. Patent Application No. 13 / 782,536. No., entitled "Surgical Instrument Soft Stop", now U.S. Patent Application Publication No. 2014/0246476.

The applicant of the present application also owns the following patent applications filed on March 14, 2013, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 13 / 803,097, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE", now U.S. Patent Application Publication No. 2014 / 026,354;
No. 13 / 803,193, entitled "CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0263537,
-U.S. Patent Application No. 13 / 803,053, entitled "INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0263564,
-U.S. Patent Application No. 13 / 803,086, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTIFICATION LOCK", now U.S. Patent Application Publication No. 2014/0263541,
No. 13 / 803,210, entitled "SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2014/0263538,
-U.S. Patent Application No. 13 / 803,148, entitled "MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0263554,
-US patent application Ser. No. 13 / 803,066, entitled "DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263565,
US patent application Ser. No. 13 / 803,117, entitled "ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263553,
No. 13 / 803,130, entitled "DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. , "METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT", currently U.S. Patent Application Publication No. 2014/0277017.

The applicant of the present application also owns the following patent application filed on March 7, 2014, the entire content of which is incorporated herein by reference:
U.S. Patent Application No. 14 / 200,111, entitled "CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2014/0263539.

The applicant of the present application also owns the following patent applications filed on March 26, 2014, which are incorporated herein by reference in their entirety:
No. 14 / 226,106, entitled "POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272582,
U.S. Patent Application No. 14 / 226,099, entitled "STERILIZATION VERIFICATION CIRCUIT", now U.S. Patent Application Publication No. 2015/0272581,
U.S. Patent Application No. 14 / 226,094, entitled "VERIFICATION OF NUMBER OF BATTERY EXCHANGES / PROCEDURE COUNT", now U.S. Patent Application Publication No. 2015/0272580,
U.S. Patent Application No. 14 / 226,117, entitled "POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL", now U.S. Patent Application Publication No. 2015/0272574,
U.S. Patent Application No. 14 / 226,075, entitled "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES", now U.S. Patent Application Publication No. 2015/0272579,
U.S. Patent Application No. 14 / 226,093, entitled "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272569,
U.S. Patent Application No. 14 / 226,116, entitled "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION", now U.S. Patent Application Publication No. 2015/0272571.
U.S. Patent Application No. 14 / 226,071, entitled "SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR", now U.S. Patent Application Publication No. 2015/0272578,
U.S. Patent Application No. 14 / 226,097, entitled "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS", now U.S. Patent Application Publication No. 2015/0272570,
U.S. Patent Application No. 14 / 226,126, entitled "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272572,
U.S. Patent Application No. 14 / 226,133, entitled "MODULAR SURGICAL INSTRUMENT SYSTEM", now U.S. Patent Application Publication No. 2015/0272557,
U.S. Patent Application No. 14 / 226,081, entitled "SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT", now U.S. Patent Application Publication No. 2015/0277471,
U.S. Patent Application No. 14 / 226,076, entitled "POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION", now U.S. Patent Application Publication No. 2015/0280424,
U.S. Patent Application No. 14 / 226,111, entitled "SURGICAL STAPLING INSTRUMENT SYSTEM", now U.S. Patent Application Publication No. 2015/0272583,
U.S. Patent Application No. 14 / 226,125, entitled "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", now U.S. Patent Application Publication No. 2015/0280384.

The applicant of the present application also owns the following patent applications filed on September 5, 2014, which are incorporated herein by reference in their respective entire contents:
No. 14 / 479,103, entitled "CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE", now U.S. Patent Application Publication No. 2016/0066912,
-U.S. Patent Application No. 14 / 479,119, entitled "ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION", now U.S. Patent Application Publication No. 2016/0066914,
-U.S. Patent Application No. 14 / 478,908, entitled "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION", now U.S. Patent Application Publication No. 2016/0066910,
-U.S. Patent Application No. 14 / 478,895, entitled "MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION", now U.S. Patent Application Publication No. 2016/0066909,
No. 14 / 479,110, entitled "USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE", now U.S. Patent Application Publication No. 2016/0066915,
No. 14 / 479,098, entitled "SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION", now U.S. Patent Application Publication No. 2016/0066911,
No. 14 / 479,115, entitled MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE, now U.S. Patent Application Publication No. 2016/0066916, and U.S. Patent Application No. 14 / 479,108, the invention Name of "LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION", currently US Patent Application Publication No. 2016/0066913.

The applicant of the present application also owns the following patent applications filed on April 9, 2014, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 248,590, entitled "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", now U.S. Patent Application Publication No. 2014/0305987,
-U.S. Patent Application No. 14 / 248,581, entitled "SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTA TABLE OUTPUT", now U.S. Patent Application Publication No. 2014/0305989.
-U.S. Patent Application No. 14 / 248,595, entitled "SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT", currently U.S. Patent Application Publication No. 2014/0305988,
-U.S. Patent Application No. 14 / 248,588, entitled "POWERED LINEAR SURGICAL STAPLER", now U.S. Patent Application Publication No. 2014/0309666,
-U.S. Patent Application No. 14 / 248,591, entitled "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0305991,
-U.S. Patent Application No. 14 / 248,584, entitled "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS", currently U.S. Patent Application Publication No. 2014/0305994,
No. 14 / 248,587, entitled POWERED SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309665,
-U.S. Patent Application No. 14 / 248,586, entitled "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. The present application entitled "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", currently U.S. Patent Application Publication No. 2014/0305992.

The applicant of the present application also owns the following patent applications filed on April 16, 2013, which are incorporated herein by reference in their entirety:
US Provisional Patent Application No. 61 / 812,365, entitled "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR",
-US Provisional Patent Application No. 61 / 812,376, entitled "LINEAR CUTTER WITH POWER",
-US Provisional Patent Application No. 61 / 812,382, entitled "LINEAR CUTTER WITH MOTOR AND PISTOL GRIP",
-U.S. Provisional Patent Application No. 61 / 812,385, "SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL", and-U.S. Provisional Patent Application No. 61 / 812,372, "SURGICAL INSTRUMENT WITH" MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR.

  Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described herein and illustrated in the accompanying drawings. Well-known operations, components and elements have not been described in detail in order not to obscure the embodiments described herein. It is understood by the reader that the embodiments described and illustrated herein are non-limiting examples, and thus the specific structural and functional details disclosed herein are exemplary and exemplary. It will be understood to get. Variations and modifications thereto can be made without departing from the scope of the claims.

  The terms "comprise" (any term form of comprise, such as "comprises" and "comprises"), "have" (any term of have, such as "has" and "having", "include" (any form of include such as "includes" and "including") and "contain" (any form of contain such as "contains" and "containing") It is a verb. As a result, a surgical system, device, or apparatus that “comprises”, “has”, “includes”, or “contains” one or more elements is one of them. It has one or more elements, but is not limited to having only one or more elements. Similarly, elements of a system, device, or apparatus that “comprise”, “have”, “include”, or “contain” one or more features are It has one or more features, but is not limited to having only one or more features.

  The terms "proximal" and "distal" are used herein as a reference to a clinician who manipulates the handle of a surgical instrument. The term "proximal" refers to the part closest to the clinician and the term "distal" refers to the part at a distance from the clinician. It will be further understood that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "above", and "below" may be used herein for the drawings. I will. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

  Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, it is readily understood by the reader that the various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, those associated with open surgical procedures. Will. By reading the "Forms for Carrying Out the Invention" herein, the reader can use the various instruments disclosed herein to create an incision or puncture in the tissue, eg, through a natural opening. It will be further understood that it can be inserted into the body in any way, such as through a hole. The working or end effector portion of these instruments can be inserted directly into the patient's body or through the access device with working channels that allow the surgical tool end effector and the elongate shaft to be advanced It can also be done.

  The surgical stapling system can include a shaft and an end effector extending from the shaft. The end effector includes a first jaw and a second jaw. The first jaw includes a staple cartridge. The staple cartridge is insertable into and removable from the first jaw, but the staple cartridge is not removable from the first jaw, or at least not easily replaceable. Other embodiments are also envisioned. The second jaw includes an anvil configured to deform the staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about a closure axis, while the first jaw is pivotable relative to the second jaw. Embodiments are also recalled. The surgical stapling system further includes an articulation joint configured to allow the end effector to rotate or articulate relative to the shaft. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments not involving articulating joints are also envisioned.

  The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal and distal ends. In use, the staple cartridge is positioned on a first side of the tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp tissue against the deck. The staples removably stored in the cartridge body can then be deployed in the tissue. The cartridge body includes a staple cavity defined therein, wherein the staples are removably stored within the staple cavity. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are located on the first side of the longitudinal slot, and three rows of staple cavities are located on the second side of the longitudinal slot. Other arrangements of staple cavities and staples may also be possible.

  The staples are supported by a staple driver in the cartridge body. The driver is movable between a first or unfired position and a second or firing position which ejects the staples from the staple cavity. The driver is retained within the cartridge body by a retainer extending around the bottom of the cartridge body, and includes an elastic member configured to grip the cartridge body and retain the retainer relative to the cartridge body. . The drivers are movable by their threads between their unfired position and their fired position. The thread is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The sled slides under the driver and includes a plurality of ramps configured to lift the driver, with the staples supported thereon and towards the anvil.

  In addition to the above, the sled is moved distally by the firing member. The firing member is configured to contact the sled and push the sled towards the distal end. A longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further includes a first cam engaging the first jaw and a second cam engaging the second jaw. When advancing the firing member distally, the first and second cams can control the distance between the deck of the staple cartridge and the anvil, ie, the tissue clearance. The firing member also includes a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. It is desirable that the knife be positioned at least partially proximal to the bevel so that the staples are ejected forward of the knife.

  FIG. 1 illustrates a powered surgical system 10 that can be used to perform a variety of different surgical procedures. In the illustrated embodiment, the powered surgical system 10 includes a selectively reconfigurable housing or handle assembly 20 mounted in one form of a replaceable surgical tool assembly 1000. For example, the system 10 shown in FIG. 1 includes a replaceable surgical tool assembly 1000 that includes a surgical cutting and fastening instrument, sometimes referred to as an endcutter. As described in further detail below, the interchangeable surgical tool assembly may include end effectors adapted to support different sizes and types of staple cartridges, and may have different shaft lengths, sizes, and It may have a type or the like. Such devices may, for example, clamp tissue using any suitable fastener (s). For example, a fastener cartridge including a plurality of fasteners removably stored therein may be removably inserted and / or attached to the end effector of the surgical tool assembly. Other surgical tool assemblies may be used interchangeably with the handle assembly 20. For example, replaceable surgical tool assembly 1000 may be removed from handle assembly 20 and replaced with a different surgical tool assembly configured to perform other surgical procedures. In other configurations, the surgical tool assembly may not be interchangeable with other surgical tool assemblies, for example, including essentially a dedicated shaft that is nonremovably secured or coupled with the handle assembly 20. Good. The surgical tool assembly may also be referred to as an elongate shaft assembly. The surgical tool assembly may be reusable or, in other configurations, the surgical tool assembly may be designed to be disposed of after a single use.

  DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS As we read through the Detailed Description of the Invention, the various forms of interchangeable surgical tool assemblies disclosed herein can be effectively used in conjunction with a robotically controlled surgical system. Will also be understood. Thus, the terms "housing" and "housing assembly" also generate at least one control motion that can be used to actuate the elongate shaft assemblies disclosed herein and their respective equivalents. A housing or similar portion of a robotic system may be included that houses or otherwise operably supports at least one drive system configured to apply. The term "frame" may refer to a portion of a hand-held surgical instrument. The term "frame" may also refer to a portion of a robotically controlled surgical instrument and / or a portion of a robotic system that may be used to operatively control a surgical instrument. For example, the surgical tool assembly disclosed herein is incorporated herein by reference in its entirety, US Patent Application No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS". US Patent Application Publication No. 2012/0298719, which can now be used with various robotic systems, instruments, components, and methods that are not limited thereto.

  Referring now to FIGS. 1 and 2, the housing assembly or handle assembly 20 includes a main housing portion 30 which may be formed from a pair of housing portions 40, 70, which are plastic, polymer, and the like. It may be manufactured from a material, metal or the like and may be joined together by a suitable fastener arrangement, such as, for example, an adhesive, a screw, a press-fit mechanism, a snap-fit mechanism, a latch or the like. As described in further detail below, the main housing portion 30 operatively supports the plurality of drive systems therein. The drive system is configured to generate various control operations and apply the control operations to corresponding portions of the replaceable surgical tool assembly operably attached to the drive system. The handle assembly 20 further includes a grip portion 100 movably coupled to the main housing portion 30 and configured to allow a physician to grip and manipulate the grip portion 100 at various positions relative to the main housing portion 30. . The grip 100 may be manufactured from a pair of grip portions 110, 120, which may be made of plastic, polymeric material, metal or the like, and for purposes of assembly and maintenance, for example, adhesives, screws, press-fit mechanisms, snap-fit mechanisms Are joined together by a suitable fastener arrangement such as a latch or the like.

  As can be seen in FIG. 2, the grip 100 includes a grip housing 130 defining a hollow cavity 132 configured to operably support a drive motor and gearbox as described in further detail below. An upper portion 134 of the gripping housing 130 is configured to extend through the opening 80 in the main housing portion 30 to pivotally support the pivot shaft 180. The pivot shaft 180 defines a pivot axis labeled "PA". See FIG. For reference purposes, the handle assembly 20 may be parallel to the shaft axis "SA" of the elongated shaft assembly of the replaceable surgical tool operably attached to the handle assembly 20, with the handle axis designated "HA" Define. The pivot axis PA traverses the handle axis HA. See FIG. With such an arrangement, the gripper 100 pivots about the pivot axis PA relative to the main housing part 30 to a position most suitable for the type of interchangeable surgical tool assembly coupled with the handle assembly 20. It becomes possible. The grip housing 130 defines a grip axis generally designated "GA". See FIG. If the replaceable surgical tool assembly coupled with the handle assembly 20 includes, for example, an end cutter, the physician grips so that the grip axis GA is perpendicular or substantially perpendicular (angle “H1”) to the handle axis HA It may be desirable to position the part 100 relative to the main housing part 30 (referred to as the "first gripping position"). See FIG. However, if, for example, the handle assembly 20 is used to control a replaceable surgical tool assembly that includes a circular stapler, the physician may observe that the grip axis GA is at an angle of 45 degrees or about 45 degrees to the handle axis HA It may be desirable to pivot the grip 100 relative to the main housing portion 30 to a position that is, or other suitable acute angle (angle "H2"). This position is referred to herein as the "second gripping position". Drawing 5 shows grasping part 100 in a 2nd grasping position with an imaginary line.

  With reference now to FIGS. 3-5, the handle assembly 20 also includes a gripper lock system (generally designated 150) for selectively locking the gripper 100 in a desired orientation relative to the main housing part 30. including. In one configuration, the gripper lock system 150 includes an arcuate series 152 of pointed teeth 154. The teeth 154 are spaced apart from one another and form a locking groove 156 therebetween. Each lock groove 156 corresponds to a place where the grip portion 100 is locked at a specific angle. For example, in at least one configuration, the teeth 154 and the locking groove or "locking position" 156 are locked at intervals of 10-15 degrees between the first gripping position and the second gripping position of the gripping portion 100 Arranged to get. This arrangement can use two stop positions adjusted to the type of instrument used (shaft configuration). For example, in an endcutter shaft configuration, the stop position may be around 90 degrees with respect to the shaft, and in a circular stapler configuration, the angle may be approximately with respect to the shaft with arcing towards the surgeon It may be 45 degrees. The gripper lock system 150 further includes a lock button 160 having a lock configured to lock into the lock groove 156. For example, the lock button 160 is pivotally mounted on the pivot pin 131 in the main handle portion 30 such that the lock button 160 can pivot into engagement with the corresponding lock groove 156. The lock spring 164 acts to bias the lock button 160 into an engaged or locked position with the corresponding lock groove 156. The lock and tooth structure serve to allow the teeth 154 to slide past the lock when the physician presses the lock button 160. Thus, to adjust the angular position of the grip 100 relative to the main housing 30, the physician pushes the lock button 160 and then pivots the grip 100 to the desired angular position. After the gripper 100 is moved to the desired position, the physician releases the lock button 160. The lock spring 164 then biases the lock button 160 towards the series of teeth 154 so that the lock enters the corresponding lock groove 156 and holds the gripper 100 in that position during use Do.

  The handle assembly 20 operably supports the first rotational drive system 300, the second rotational drive system 320 and the third axial drive system 400. The rotary drive systems 300, 320 are each powered by a motor 200 operatively supported within the gripper 100. As can be seen from FIG. 2, for example, motor 200 has a gearbox assembly 202 supported within cavity 132 in gripper 100 and having an output drive shaft 204 projecting therefrom. In various forms, motor 200 may be, for example, a brushed DC drive motor having a maximum number of revolutions of about 25,000 RPM. In other configurations, the motor can include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor 200 may be powered by a power source 210, which may include a removable power pack 212 in one form. Power supply 210 may be, for example, any of those disclosed in more detail in US Patent Application Publication No. 2015/0272575, entitled SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM, the disclosure of which is incorporated herein by reference in its entirety. It may include any of the power supply configurations. In the illustrated configuration, for example, power pack 212 may include a proximal housing portion 214 configured to attach to distal housing portion 216. The proximal housing portion 214 and the distal housing portion 216 are configured to operably support the plurality of batteries 218 therein. The cells 218 may each include, for example, lithium ion ("LI") or other suitable cells. Distal housing portion 216 is configured to be removably and operably attached to handle circuit board assembly 220, which is also operably connected with motor 200. The handle circuit board assembly 220 may also be generally referred to herein as a "control system or CPU 224". Multiple batteries 218, which may be connected in series, may be used as a power source for the handle assembly 20. In addition, power supply 210 may be replaceable and / or rechargeable. In one embodiment, the surgical instrument 10 may be powered by, for example, alternating current (AC). The motor 200 can be controlled by a rocker switch 206 attached to the grip 100.

  As outlined above, motor 200 is operatively coupled to a gearbox assembly 202 that includes an output drive shaft 204. Attached to the output drive shaft 204 is a drive bevel gear 230. Motor 200, gearbox assembly 202, output drive shaft 204 and drive bevel gear 230 may also be generally referred to herein as "motor assembly 231". Drive bevel gear 230 interlocks with a driven bevel gear 234 attached to system drive shaft 232 as well as pivot gear 238 pivotally supported by pivot shaft 180. The driven bevel gear 234 engages with the engaged position (FIG. 5) where the driven bevel gear 234 is in meshing engagement with the drive bevel gear 230 on the system drive shaft 232 and the driven bevel gear 234 engages with the driven bevel gear 230 It is axially movable between a disengaged and disengaged position (FIG. 14). Drive system spring 235 is pivotally supported between driven bevel gear 234 and a proximal end flange 236 formed on a proximal portion of system drive shaft 232. See FIGS. 4 and 14. The drive system spring 235 serves to bias the driven bevel gear 234 to release meshing engagement with the driven bevel gear 230, as described in further detail below. Pivotal gear 238 facilitates pivotal movement of output drive shaft 204 and drive bevel gear 230 with gripping portion 100 relative to main handle portion 30.

  In the illustrated example, system drive shaft 232 interfaces with a rotary drive selector system, generally designated 240. In at least one form, for example, rotary drive selector system 240 includes a shifter gear 250 that is selectively moveable between a first rotary drive system 300 and a second rotary drive system 320. As can be seen in FIGS. 6-9, for example, the drive selector system 240 includes a shifter mounting plate 242 that is immovably mounted within the main handle portion 30. For example, the shifter mounting plate 242 may be frictionally held between mounting lugs (not shown) formed in the housing portions 40, 70, or alternatively by screws, adhesives etc. between the mounting lugs Can be held at Still referring to FIGS. 6-9, the system drive shaft 232 extends through the hole in the shifter mounting plate 242 and the central (or system) drive gear 237 is non-rotatably mounted thereto. For example, central drive gear 237 may be attached to system drive shaft 232 by keyway arrangement 233. See Figures 6-9. In other configurations, system drive shaft 232 may be rotatably supported in shifter mounting plate 242 by corresponding bearings (not shown) attached to system drive shaft 232. In any event, rotation of the system drive shaft 232 results in rotation of the central drive gear 234.

  As seen in FIG. 3, the first drive system 300 includes a first drive socket 302 rotatably supported in a distal wall 32 formed in the main handle portion 30. The first drive socket 302 may include a first body portion 304 having a spline socket formed therein. The first drive gear 306 is formed on the first body portion 304 or is immovably attached to the first body portion 304. The first body portion 304 may be rotatably supported in corresponding holes or passageways provided in the distal wall 32 or corresponding bearings mounted in the distal wall 32 (not shown) ) May be rotatably supported. Similarly, the second rotational drive system 320 includes a second drive socket 322 also rotatably supported within the distal wall 32 of the main handle portion 30. The second drive socket 322 may include a second body portion 324 having a spline socket formed therein. The second drive gear 326 is formed on the second body portion 324 or is non-rotatably attached to the second body portion 324. The second body portion 324 may be rotatably supported in corresponding holes or passages provided in the distal wall 32 or corresponding bearings mounted in the distal wall 32 (not shown) ) May be rotatably supported. The first and second drive sockets 302, 322 are spaced apart from each other on both lateral sides of the handle axis HA. See, for example, FIG.

  As mentioned above, in the illustrated example, the rotary drive selector system 240 includes the shifter gear 250. As can be seen in FIGS. 6-9, shifter gear 250 is rotatably mounted on idler shaft 252 which is movably supported in arcuate slot 244 in shifter mounting plate 242. Shifter gear 250 is free to rotate on idler shaft 252 and is mounted to maintain meshing engagement with central drive gear 234. The idler shaft 252 is coupled to the end of the shaft 262 of the shifter solenoid 260. Shifter solenoid 260 is pinned to main handle housing 30 such that when shift solenoid 260 is actuated, shifter gear 250 moves into meshing engagement with one of first drive gear 306 or second drive gear 326. Stopped or otherwise attached. For example, in one configuration, as the solenoid shaft 262 retracts (FIGS. 6 and 7), the shifter gear 250 engages the central drive gear 234 and the first drive gear 306, thereby causing the motor 200 to operate. The first drive socket 302 rotates. As can be seen from FIGS. 6 and 7, shifter spring 266 can be used to bias shifter gear 250 to this first operative position. Thus, if power to the surgical instrument 10 is lost, the shifter spring 266 will automatically bias the shifter gear 250 to the first position. With the shifter gear 250 in this position, continued actuation of the motor 200 results in rotation of the first drive socket 302 of the first rotational drive system 300. When the shifter solenoid is actuated, the shifter gear 250 moves into meshing engagement with the second drive gear 326 on the second drive socket 322. Thereafter, actuation of the motor 200 results in actuation or rotation of the second drive socket 322 of the second rotational drive system 320.

  As described in further detail below, the first and second rotary drive systems 300, 320 comprise various configurations of interchangeable surgical tool assemblies coupled to the first and second rotary drive systems 300, 320. It can be used to power element parts. As mentioned above, in at least one configuration, the shifter spring 266 biases the shifter gear 250 to the first position if power to the motor is lost during operation of the replaceable surgical tool assembly. The application of the rotational drive motion to the first drive system 300 may be reversed to remove the replaceable surgical tool assembly from the patient depending on which component part of the replaceable surgical tool assembly has been manipulated You may need to be able to The handle assembly 20 of the illustrated embodiment is, for example, a manually actuatable "escape", generally designated 330, for manually applying rotational drive motion to the first rotational drive system 300 in the scenario described above It uses a system.

  Referring now to FIGS. 3, 10 and 11, the illustrated escape system 330 includes an escape power transmission system 332 that includes a planetary gear assembly 334. In at least one form, planet gear assembly 334 includes a planet gear housing 336 that houses a planet gear arrangement (not shown) that includes planet bevel gears 338. Planetary gear assembly 334 includes an escape drive shaft 340 operatively coupled to the planetary gear arrangement within planetary gear housing 336. The rotation of the planet bevel gear 338 rotates the planet gear arrangement and eventually the escape drive shaft 340. The escape drive gear 342 is pivotally mounted on the escape drive shaft 340 such that the escape drive gear 342 axially moves on the escape drive shaft 340 and is also able to rotate with the escape drive shaft 340. The escape drive gear 342 is movable between a spring stop flange 344 formed on the escape drive shaft 340 and a shaft end stop 346 formed on the distal end of the escape drive shaft 340. The escape shaft spring 348 is pivotally supported between the escape drive gear 342 on the escape drive shaft 340 and the spring stop flange 344. The escape shaft spring 348 biases the escape drive gear 342 distally on the escape drive shaft 340. When the escape drive gear 342 is at the most distal position on the escape drive shaft 340, the escape drive gear 342 is in meshing engagement with the escape drive gear 350 that is non-rotatably attached to the system drive shaft 232. See FIG.

  Referring now to FIGS. 12 and 13, the escape system 330 includes an escape actuator assembly or escape handle assembly 360 that facilitates the manual application of the escape drive motion to the escape power transmission system 332. As can be seen from these figures, the escape handle assembly 360 includes an escape bevel gear assembly 362 that includes an escape bevel gear 364 and a ratchet gear 366. The escape handle assembly 360 further includes an escape handle 370 movably coupled to the escape bevel gear assembly 362 by a pivoting yoke 372 pivotally mounted on a ratchet gear 366. The escape handle 370 is pivotally coupled to the pivoting yoke 372 by a pin 374 to selectively pivotably move between a stored position "SP" and an actuated position "AP". See FIG. A handle spring 376 is used to bias the escape handle 370 to the actuated position AP. In at least one configuration, the angle between the axis SP representing the storage position and the axis AP representing the actuation position may be, for example, about 30 degrees. See FIG. As also seen in FIG. 13, the escape handle assembly 360 further includes a ratchet pole 378 rotatably mounted in a cavity or hole 377 in the pivoting yoke 372. The ratchet pole 378 is configured to meshingly engage the ratchet gear 366 when rotated in the actuating direction "AD" and then rotate to release the meshing engagement when rotated in the opposite direction. ing. The ratchet spring 384 and the ball member 386 are movably supported within the cavity 379 in the pivoting yoke 372 and detent of the ratchet pole 378 when the escape handle 370 is actuated (ratcheted) It plays a role in locking engagement with 380 and 382.

  Referring now to FIGS. 3 and 10, the escape system 330 further includes an escape access panel 390 operable between an open position and a closed position. In the illustrated configuration, the escape access panel 390 is configured to be removably coupled to the housing portion 70 of the main housing portion 30. Thus, at least in this embodiment, when the escape access panel 390 is removed from or removed from the main housing portion 30, it is said to be in the "open" position and the escape access panel 390 is the main housing portion 30. When attached to, say it is in the "closed" position. However, other embodiments are contemplated where the access panel is movably coupled to the main housing portion such that the access panel remains attached to the main housing portion when the access panel is in the open position. For example, in such an embodiment, the access panel is pivotally attached to the main housing portion or slidably attached to the main housing portion to be operable between an open position and a closed position. It may be taken. In the illustrated example, the escape access panel 390 is configured to snap into engagement with a corresponding portion of the housing portion 70 to releasably retain the escape access panel 390 in the "closed" position. It is also possible to use other forms of mechanical fasteners such as screws, pins etc.

  Regardless of whether the escape access panel 390 is removable from the main housing portion 30 or remains movably attached to the main housing portion 30, the escape access panel 390 can be coupled with a drive system lock member or yoke 392 An escape lock member or yoke 396, which respectively protrudes from the back side of the escape access panel 390 or is otherwise formed on the escape access panel 390. Drive system lock yoke 392 receives a portion of system drive shaft 232 therein when escape access panel 390 is installed in main housing portion 30 (ie, the escape access panel is in the "closed" position) And a drive shaft notch 394 configured in FIG. Drive system lock yoke 392 biases driven bevel gear 234 (against the bias of drive system spring 235) to drive bevel gear 230 when exit access panel 390 is positioned or installed in the closed position. It plays a role in meshing engagement. Additionally, the escape lock yoke 396 is configured for receiving a portion of the escape drive shaft 340 therein when the escape access panel 390 is installed or positioned in the closed position. Including 397. As can be seen from FIGS. 5 and 10, the escape lock yoke 396 also biases the escape drive gear 342 (against the bias of the escape shaft spring 348) to release the meshing engagement with the escape drive gear 350. Play a role. In this way, the escape lock yoke 396 prevents the escape drive gear 342 from blocking rotation of the system drive shaft 232 when the escape access panel 390 is installed or in the closed position. Additionally, the escape lock yoke 396 includes a handle notch 398 for engaging the escape handle 370 and holding it in the storage position SP.

  FIGS. 4, 5 and 10 illustrate the structure of drive system components and escape system components when the escape access panel 390 is installed or in the closed position. As can be seen from these figures, drive system lock member 392 biases follower bevel gear 234 into meshing engagement with drive bevel gear 230. Thus, actuation of motor 200 when escape access panel 390 is installed or in the closed position results in rotation of drive bevel gear 230 and ultimately rotation of system drive shaft 232. Also in this position, the escape lock yoke 396 acts to urge the escape drive gear 342 to release the meshing engagement with the escape drive gear 350 on the system drive shaft 232. Thus, when the escape access panel 390 is installed or in the closed position, the drive system can be actuated by the motor 200 and the escape system 330 can be separated from the system drive shaft 232 or the system drive shaft 232. Can not add to the exercise movement. To activate the escape system 330, the physician first removes the escape access panel 390 or otherwise moves the escape access panel 390 to the open position. This action disengages the drive system lock member 392 from engagement with the driven bevel gear 234, whereby the drive system spring 235 biases the driven bevel gear 234 to disengage the engaged engagement with the driven bevel gear 230. Make it possible. In addition, removing escape access panel 390 or moving the escape access panel to the open position also results in escape lock yoke 396 disengaging with escape drive gear 342, thereby causing escape shaft spring 348 to The escape drive gear 342 can be biased into meshing engagement with the escape drive gear 350 on the system drive shaft 232. Therefore, rotation of the escape drive gear 342 results in rotation of the escape drive gear 350 and the system drive shaft 232. The handle spring 376 also biases the escape handle 370 to the actuated position shown in FIGS. 11 and 14 by removing the escape access panel 390 or otherwise moving the escape access panel 390 to the open position. It becomes possible. When in this position, the physician can manually ratchet the escape handle 370 in the ratcheting direction RD, resulting in rotation of the ratchet bevel gear 364 (eg, in the clockwise direction of FIG. 14). As a result, backward rotational motion is imparted to the system drive shaft 232 through the escape power transmission system 332. The physician repeatedly rotates the escape handle 370 many times until the system drive shaft 232 is sufficiently rotated a number of times sufficient to retract the surgical end effector portion of the surgical tool assembly attached to the handle assembly 20. It can be ratcheted. Once escape system 330 is fully actuated manually, the physician then returns escape access panel 390 to its original position (ie, returns escape access panel 390 to the closed position), thereby causing drive system lock member 392 to Can force the bevel gear 234 into meshing engagement with the drive bevel gear 230 and the escape lock yoke 396 can urge the escape drive gear 342 into disengagement with the escape drive gear 350. As noted above, if power is lost or interrupted, shifter spring 266 will bias shifter solenoid 260 to the first actuated position. Thus, activating the escape system 330 results in the first rotational drive system 300 being given a retrograde or reverse motion.

  As mentioned above, the surgical stapling instrument can include, for example, a manually actuated escape system configured to retract the staple firing drive. In many cases, it may be necessary to operate and / or crank the escape system more than once to fully retract the staple firing drive. In such cases, the user of the stapling instrument may not know how many times the escapement has been cranked and / or may be confused as to how far the firing drive needs to be retracted. A stapling instrument detects the position of the firing member of the firing drive, determines the distance over which the firing member needs to be retracted, and displays the distance to the user of the surgical instrument Various embodiments are envisioned, including.

  In at least one embodiment, the surgical stapling instrument includes one or more sensors configured to detect the position of the firing member. In at least one case, the sensor may, for example, comprise a Hall effect sensor, which may be positioned within the shaft of the stapling instrument and / or the end effector. The sensor is in signal communication with a controller of the surgical stapling instrument, which in turn is in signal communication with a display of the surgical stapling instrument. The controller includes a microprocessor, which compares the actual position of the firing member to a reference (or reference) position (including the fully retracted position of the firing member), and the actual position and reference position of the firing member. Are configured to calculate the distance between them (i.e., the remaining distance).

  In addition to the above, the display includes, for example, an electronic display, and the controller is configured to display the remaining distance on the electronic display in any suitable manner. In at least one case, the controller displays a progress bar on the display. In such a case, for example, an empty progress bar can indicate that the firing member is at the end of its firing stroke, and when the progress bar is filled, the firing member has been completely retracted Can be represented. In at least one case, for example, 0% can represent that the firing member is at the end of its firing stroke, and 100% can represent that the firing member has completely retracted. In some cases, the controller is configured to display on the display how many times the escape mechanism needs to be actuated to retract the firing member to its fully retracted position.

  In addition to the above, actuation of the escape mechanism can operatively disconnect the battery or power source of the surgical stapling instrument from the electric motor of the firing drive. In at least one embodiment, actuation of the escape mechanism turns on a switch that electrically decouples the battery from the electric motor. Such systems will prevent the electric motor from resisting manual retraction of the launch member.

  The illustrated handle assembly 20 also supports a third axial drive system, generally labeled 400. As can be seen in FIGS. 3 and 4, in at least one form, the third axial drive system 400 includes a solenoid 402 from which a third drive actuator member or rod 410 projects. The distal end 412 of the third drive actuator member 410 has a third drive cradle or socket 414 formed therein and is operably attached to the third drive cradle or socket 414. Receive the corresponding part of the drive system component of The solenoid 402 is wired to or otherwise communicates with the handle circuit board assembly 220 and the control system or CPU 224. In at least one configuration, the solenoid 402 is "spring-loaded" so that when the solenoid 402 is not actuated, its spring component returns the third drive actuator 410 to the unactuated start position. Energize.

  As mentioned above, the reconfigurable handle assembly 20 may be advantageously used to actuate a variety of different replaceable surgical tool assemblies. To that end, the handle assembly 20 includes a tool mount, generally designated 500, for operably coupling the replaceable surgical tool assembly to the handle assembly 20. In the illustrated example, the tool mount 500 includes two inward facing dovetail receiving slots 502 configured to engage corresponding portions of the tool mount module portion of the replaceable surgical tool assembly. Each dovetail receiving slot 502 may be tapered or, in other words, somewhat V-shaped. Dovetail receiving slot 502 is configured to releasably receive a corresponding tapered attachment or protrusion formed on a portion of the tool mounting nozzle portion of the replaceable surgical tool assembly. Each replaceable surgical tool assembly may also include a latching system configured to releasably engage a corresponding retention pocket 504 formed in the tool mount 500 of the handle assembly 20.

  Various interchangeable surgical tool assemblies may be operatively coupled to or interlocked with the first rotational drive system 310 as a "primary" rotational drive system, as well as operating with the second rotational drive system 320. It may have a "secondary" rotary drive system configured to be coupled or interlocked as possible. The primary and secondary rotational drive systems may be configured to provide various rotational motions to a portion of the particular type of surgical end effector that forms part of the replaceable surgical tool assembly. Tool attachment of the handle assembly 20 to facilitate operable coupling of the primary rotational drive system to the first rotational drive system and operable coupling of the secondary drive system to the second rotational drive system 320 Portion 500 further includes a pair of insertion ramps 506. The pair of insertion ramps 506 biases portions of the primary and secondary rotary drive systems of the replaceable surgical tool assembly distally during the coupling process to provide for rotation on the primary rotary drive system Alignment and operable connection with the first rotary drive system 300, and alignment and operable connection between the secondary rotary drive system and the second rotary drive system 320 on the handle assembly 20 It is configured to

  The replaceable surgical tool assembly can include a "tertiary" axis drive system for applying axial motion (s) to corresponding portions of the surgical end effector of the replaceable surgical tool assembly. To facilitate operable coupling of the tertiary axis drive system with the third axis drive system 400 on the handle assembly 20, the third drive actuator member 410 can be a projection or other portion of the tertiary axis drive system. And a socket 414 configured to operatively receive the

  A replaceable tool assembly 2000 is shown in FIG. Replaceable tool assembly 2000 is similar to replaceable tool assembly 1000 in many respects, but differs from replaceable tool assembly 1000 in several other respects. For example, replaceable assembly 2000 is a circular stapling assembly. Referring primarily to FIGS. 15 and 16, the circular stapling assembly 2000 includes a shaft portion 2100 and an end effector 2200. Shaft portion 2100 includes, for example, a proximal portion that is removably attachable to handle assembly 20. End effector 2200 includes a first portion 2210 rotatably mounted to shaft portion 2100 about articulation joint 2300. End effector 2200 further includes a second portion 2220 removably attached to first portion 2210. The second portion 2220 includes a cartridge portion 2222 that includes an annular array of staple cavities 2224 defined therein, and a staple stored within each staple cavity 2224. The second portion 2220 further includes an anvil 2230 including a tissue compression surface 2232 and an annular array or formation pocket 2234 (FIG. 27) of formation pockets aligned with the staple cavities 2224, the formation pockets being staples It is configured to deform the staples when ejected from the staple cavity 2224.

  In addition to the above, referring again to FIGS. 15 and 16, the second portion 2220 of the end effector 2200 is selectively attachable to the first portion 2210 of the end effector 2200, and the first portion 2210. Are selectively removable from Second portion 2220 includes outer housing 2227 including proximal connector 2229, which is received within an opening (or chamber) 2218 defined in housing 2217 of first portion 2210. Is configured as. The fit between the connector 2229 of the housing 2227 and the housing 2217 of the first portion 2210 is a slip fit. The compression fit between the connector 2229 and the housing 2217 can prevent the second portion 2220 from inadvertently displacing the first portion 2210 in the longitudinal and / or rotational directions. In various examples, a detent member may be utilized to releasably secure the second portion 2220 of the end effector 2200 to the first portion 2210.

  With reference to FIGS. 15 and 35-38, the second portion 2220 of the end effector 2200 is another second portion, eg, a second portion 2220 ', a second portion 2220' ', a second It is interchangeable with a portion 2220 ′ ′ ′ and / or another second portion 2220 or the like. The second portions 2220 ′, 2220 ′ ′ and 2220 ′ ′ are similar in many respects to the second portion 2220. For example, each of the second portions 2220, 2220 ', 2220 ", and 2220"' includes a central opening 2226 defined therein. However, the second portions 2220 ′, 2220 ′ ′ and 2220 ′ ′ are otherwise different from the second portion 2220. For example, the second portion 2220 'has a larger diameter than the second portion 2220. Further, the annular array of staple cavities 2224 defined in the second portion 2220 'has a larger circumferential diameter than the annular array of staple cavities 2224 defined in the second portion 2220. Similarly, the second portion 2220 ′ ′ has a larger diameter than the second portion 2220 ′, and the annular array of staple cavities 2224 defined in the second portion 2220 ′ ′ is second Have a circumferential diameter greater than the annular array of staple cavities 2224 defined in the portion 2220 'of the. Furthermore, likewise, the second portion 2220 ′ ′ ′ has a larger diameter than the second portion 2220 ′ ′ and the annular shape of the staple cavity 2224 defined in the second portion 2220 ′ ′ ′. The array has a circumferential diameter greater than the annular array of staple cavities 2224 defined in the second portion 2220 ''.

  In addition to the above, the anvil 2230 can be replaced with other anvils, such as, for example, anvil 2230 ', anvil 2230 ", anvil 2230"' and / or another anvil 2230 or the like. The anvils 2230 ', 2230 "and 2230"' are similar to the anvil 2230 in many respects. For example, each anvil 2230, 2230 ′, 2230 ′ ′, and 2230 ′ ′ ′ includes a longitudinal shaft 2236 that includes a connecting flange 2238. However, the anvils 2230 ', 2230 "and 2230"' are different from the anvil 2230 in other respects. For example, the anvil 2230 'has a larger diameter than the anvil 2230. Further, the annular array of formed pockets 2234 defined in the anvil 2230 'is anvil such that the formed pockets 2234 remain aligned with the staple cavities 2224 defined in the second portion 2220'. It has a larger circumferential diameter than the annular array of formed pockets 2234 defined in 2230. Furthermore, the anvil 2230 '' has a larger diameter than the anvil 2230 'such that the forming pocket 2234 remains aligned with the staple cavity 2224 defined in the second portion 2220' '. The annular array of forming pockets 2234 defined in the anvil 2230 '' has a larger circumferential diameter than the annular array of forming pockets 2234 defined in the anvil 2230 '. Further, similarly, the anvil 2230 "'is further extended from the anvil 2230" so that the forming pocket 2234 remains aligned with the staple cavity 2224 defined in the second portion 2220 "'. The annular array of formed pockets 2234 defined in the second portion 2220 ′ ′ ′ also has a larger diameter and the circumferential diameter is larger than the annular array of formed pockets 2234 defined in the anvil 2230 ′ ′. have.

  Referring primarily to FIG. 17, shaft portion 2100 includes a proximal connector 2120 and an elongate shaft portion 2110 extending distally from proximal connector 2120. Proximal connector 2120 includes a first input 2318 and a second input 2418. The first input 2318 is operatively connected to the articulation system of the end effector and the second input 2418 is operatively connected to the clamp and staple firing system of the end effector. The first input 2318 and the second input 2418 can operate in any suitable order. For example, the first input portion 2318 may be rotated in a first direction to articulate the end effector 2200 in a first direction, and correspondingly rotated in a second direction to rotate the end effector 2200. Articulated in a second direction. Once the end effector 2200 is properly articulated, the second input 2428 can then be rotated to close the anvil 2230 and clamp tissue against the cartridge portion 2222 of the end effector 2200. The second input 2428 can then be manipulated to fire the staples from the staple cavity 2224 to dissect tissue captured in the end effector 2200, as described in further detail below. In various alternative embodiments, the first input 2318 and the second input 2328 can be operated in any suitable order and / or simultaneously.

  The first input 2318 is attached to the proximal end of an articulation shaft 2310 rotatably attached to the shaft 2010. Referring primarily to FIGS. 20 and 21, the rotatable articulation shaft 2310 includes a distal end and a worm gear 2312 mounted at the distal end. The worm gear 2312 is screwed into the joint sliding portion 2320. More specifically, the joint slide 2320 includes a threaded opening 2322 defined therein, and the worm gear 2312 threadingly engages with the threaded opening 2322. When articulation shaft 2310 rotates in a first direction, worm gear 2312 pushes articulation slide 2320 distally (FIG. 32). When articulation shaft 2310 rotates in the second or opposite direction, worm gear 2312 pushes articulation slide 2320 proximally (FIG. 31). The articulation slide 2320 is slidably supported by an articulation block 2112 fixedly mounted in the distal end of the elongate shaft 2110. Movement of the articulation slide 2320 is limited to proximal and distal movement by the articulation block 2112 by a guide slot 2315 defined in the articulation block 2112. The joint slide 2320 further includes a longitudinal key portion 2326 extending from the joint slide 2320, which is received snugly in the longitudinal key groove 2116 defined in the bottom of the guide slot 2315, the key Portion 2326 limits relative motion between articulation slide 2320 and articulation block 2112 to a longitudinal path.

  Referring again to FIGS. 20, 21 and 24, the articulation slide 2320 is coupled with the articulation link 2330. The articulation slide 2320 includes a drive pin 2324 extending from the articulation slide 2320, which is positioned within the proximal opening 2334 defined in the articulation link 2330. The drive pin 2324 is snugly received within the opening 2334 so that the drive pin 2324 and the sidewall of the opening 2334 cooperate to provide a rotational axis between the articulation slide 2320 and the articulation link 2330. Define. Articulation link 2330 is also coupled to end effector 2200 housing 2217. More specifically, articulation link 2330 further includes a distal opening 2335 defined within articulation link 2330 and housing 2217 includes a pin 2215 positioned within distal opening 2335. The pin 2215 is snugly received within the opening 2335 so that the pin 2215 and the sidewall of the opening 2335 cooperate to define an axis of rotation between the articulation link 2330 and the housing 2217.

  In addition to the above, referring to FIGS. 18-21 and 24, end effector 2200 is rotatably coupled with articulation block 2112 of shaft 2100 about articulation joint 2300. The housing 2217 of the end effector 2200 includes an opening 2213 defined in the opposite surface of the housing 2217, and the articulation block 2112 includes a protrusion 2113 extending from the opposite surface of the articulation block 2112, the protrusion being 2113 is positioned within the opening 2213. Protrusion 2113 is snugly received within opening 2213 so that articulation 2113 can cooperate with the side wall of opening 2213 to allow end effector 2200 to articulate thereabout. Define As articulation shaft 2310 rotates to drive articulation slide 2320 distally, articulation slide 2320 drives the proximal end of articulation link 2330 distally. In response to distal movement of the proximal end of articulation link 2330, articulation link 2330 rotates about drive pin 2324, which causes end effector 2200 to rotate about articulation joint 2300. As articulation input 2310 is rotated to drive joint slide 2320 proximally, joint slide 2320 pulls the proximal end of articulation link 2330 proximally, as described above. In response to proximal movement of the proximal end of articulation link 2330, articulation link 2330 rotates about drive pin 2324, which causes end effector 2200 to rotate about articulation joint 2300. Articulation link 2330 provides at least one degree of freedom between articulation slide 2320 and housing 2217. As a result, articulation link 2330 can articulate end effector 2200 across a wide range of articulation angles.

  As mentioned above, referring to FIGS. 17 and 25, the proximal connector 2120 of the interchangeable tool assembly 2000 includes a second input 2418. The second input 2418 includes a drive gear 2417 in meshing engagement with a drive gear 2416 mounted at the proximal end of the drive shaft 2410. The drive shaft 2410 extends through the shaft portion 2110 and an opening 2114 defined in an articulation block 2112 illustrated in FIG. Opening 2114 includes a bearing and rotatably supports drive shaft 2410. Alternatively, the opening 2114 may include a clearance opening. In either case, referring primarily to FIG. 22, drive shaft 2410 extends through articulation joint 2300 into a chamber 2218 defined in end effector housing 2217. Drive shaft 2410 is rotatably supported by bearings 2414 mounted on drive shaft 2410, which are captured in recesses 2214 defined in housing 2217 of end effector 2200. Drive shaft 2410 further includes an output gear 2412 mounted at the distal end of drive shaft 2410 such that rotation of drive shaft 2410 is transmitted to output gear 2412.

  Referring primarily to FIGS. 18, 22 and 23, the output gear 2412 of the drive shaft 2410 operatively engages the transmission 2420. As will be described in more detail below, the transmission 2420 includes the end effector 2200 in a first mode of operation in which the drive shaft 2410 moves the anvil 2230 relative to the cartridge body 222 and the drive shaft 2410 from the staple cavity 2224 A staple is fired and configured to transition between a second mode of operation in which tissue captured between the anvil 2230 and the cartridge body 222 is incised. The transmission 2420 includes a track drive that includes a planet plate 2421 and four planet gears 2424 rotatably mounted to the planet plate 2421. The planet plate 2421 includes a clearance opening extending through the center of the planet plate 2421 and a drive shaft 2410 extending through the clearance opening. The planets 2421 and planet gears 2424 are positioned within a chamber 2219 defined within the housing 2217 of the end effector. Each planet gear 2424 is rotatable about a gear pin 2423 extending from the planet plate 2421. The gear pin 2423 is positioned along the circumference surrounding the clearance opening. The output gear 2412 is in meshing engagement with the planet gear 2424 and the drive shaft 2410 drives the planet gear 2424 as described in more detail below.

  In addition to the above, drive shaft 2410 extends through articulation joint 2300. The drive shaft 2410 is flexible so that the output gear 2412 maintains proper engagement with the planet gear 2424 when the end effector 2200 articulates. In at least one case, drive shaft 2410 is made of, for example, plastic.

  As mentioned above, transmission 2420 includes a first mode of operation and a second mode of operation. Referring primarily to FIGS. 23 and 28, the replaceable tool assembly 2000 has a first position and a second position to switch the transmission 2420 between its first mode of operation and its second mode of operation. And a shifter 2600 movable between the position of. When the shifter 2600 is in its first position, as illustrated in FIGS. 28-30, the shifter 2600 does not engage the planet 2421 of the transmission 2420 so that the planet 2421 and the planet gear 2424 do not. It is rotated by drive shaft 2410. More specifically, as will be described in more detail below, drive shafts 2410 rotate planet gears 2424 about their corresponding gear pins 2423, planet gears 2424 include planet gears 2424 and planet gears 2424. The reaction force between the circumferentially extending teeth 2534 and the annular ring causes the planet 2421 to rotate. The planet 2421 is operatively coupled to the output coupling 2430 such that rotation of the planet 2421 is transmitted to the output coupling 2430. Referring mainly to FIG. 23, the output connection 2430 includes an array of openings 2433 extending around the outer periphery of the output connection 2430, and the gear pins 2423 extending from the planets 2421 receive the output connection 2430. The opening 2433 extends into and is received snugly by the opening 2433 so that there is little if any relative movement between the planet plate 2421 and the output connection 2430.

  Referring primarily to FIGS. 18 and 23, the output connection 2430 includes a drive socket 2432. The drive socket 2432 includes, for example, a substantially hexagonal opening. However, any suitable configuration can be used. The drive socket 2432 is configured to receive a closure shaft 2440 extending through the second portion 2220 of the end effector 2200. The closure shaft 2440 includes a proximal drive end 2442 having a generally hexagonal shape, the proximal drive end 2442 being within the drive socket 2432 such that rotation of the drive shaft 2410 can be transmitted to the closure shaft 2440 Be snugly accepted. The closure shaft 2440 is rotatably supported within the housing 2227 of the second portion 2220 by bearings 2444. Bearings 2444 include, for example, thrust bearings, although bearings 2444 may include any suitable bearing.

  Referring primarily to FIGS. 23 and 28-30, the closure shaft 2440 includes a threaded portion 2446 threadedly engaged with a threaded opening 2456 defined in the trocar 2450. As described in further detail below, anvil 2230 is attachable to trocar 2450, which translates to move anvil 2230 toward and / or away from cartridge body 2222. be able to. Referring again to FIG. 18, the trocar 2450 includes at least one longitudinal key slot 2459 defined in the trocar 2450, the key slot 2459 extending from the inner surface 2546 of the drive sleeve 2540. It is configured to cooperate with the longitudinal key. The drive sleeve 2540 is part of the staple firing system described further below, and the reader is that the trocar 2450 and the drive sleeve 2540 slide relative to one another in the first, and secondly It should be understood that they cooperate to prevent relative rotation between them. The threaded engagement between the closure shaft 2440 and the trocar 2450 allows the closure shaft 2440 to dislocate or translate the trocar 2450 distally as the closure shaft 2440 rotates in a first direction, corresponding to that The trocar 2450 can then be displaced or translated proximally as the closure shaft 2440 rotates in the second or opposite direction.

  As mentioned above, anvil 2230 is attachable to trocar 2450. Anvil 2230 includes a connecting flange 2238 configured to engage and grip trocar 2450. Connection flange 2238 includes a cantilever connected to shaft portion 2236 of anvil 2230. Referring primarily to FIG. 23, trocar 2450 includes a retention notch (or (or recess) 2458 configured to releasably receive connecting flange 2238 when anvil 2230 is assembled to trocar 2450. Retention notch 2458 and connecting flange 2238 are configured to resist unintended separation of anvil 2230 from trocar 2450. Connecting flange 2238 is separated by longitudinal slots 2237. Longitudinal The slot 2237 is configured to receive the longitudinal rib 2457 extending from the trocar 2450 when the anvil 2230 is assembled to the trocar 2450. The rib 2457 is snugly received within the slot 2237 so that , Anvil 2230 To rotate is blocked against locale 2450.

  Once the anvil 2230 is properly positioned relative to the cartridge portion 2222, the tool assembly 2000 can be transitioned to its second mode of operation as described above. The shifter 2600 includes, for example, an electrically operated motor used to move the transmission 2420 of the end effector 2200. In various other embodiments, the shifter 2600 can include any suitable device that is operated electrically and / or manually. A shifter 2600 is in signal communication with the processor of the surgical stapling instrument and in electrical communication with the battery of the surgical stapling instrument. In various examples, for example, an insulated wire extends between the shifter 2600 and the handle of the surgical instrument so that the processor can communicate with the shifter 2600 and the battery can provide power to the shifter 2600 It is also good. In various other examples, shifter 2600 can include a wireless signal receiver, and a processor can be in wireless communication with shifter 2600. In some cases, power may be wirelessly supplied to shifter 2600, such as by an inductive circuit or the like. In various examples, shifter 2600 can include its own power supply.

  Shifter 2600 includes a housing mounted within a chamber 2218 defined within the proximal end of end effector 2200. Shifter 2600 includes a clutch key (or toggle) 2602 and an output shaft 2604 movable between a first position and a second position relative to the shifter housing. The clutch key 2602 includes one lock tooth 2608 and a second lock tooth 2609, and when the clutch key 2602 is in its first position, the first lock tooth 2608 is to the firing tube 2530 of the staple firing system. Engaging and at the same time, the second locking tooth 2609 releases the engagement of the transmission 2420 with the planet 2421. More specifically, the first locking tooth 2608 is positioned within the opening 2538 which is part of an annular array of openings 2538 defined around the firing tube 2530 and the second locking tooth 2609 is It is not positioned within the opening 2429 which is part of an annular array of openings 2429 defined around the planets 2421. As a result of the above, when the clutch key 2602 is in its first position, the shifter 2600 prevents the firing tube 2530 from rotating, thereby locking out the staple firing system. When the clutch key 2602 is in its first position, the staple firing system is locked out by the shifter 2600 but the drive shaft 2410 rotates the planet plate 2421 to operate the anvil closure system as described above. be able to.

  As primarily shown in FIG. 23, the firing tube 2530 includes an inner annular rack of teeth 2534 defined in its inner sidewall 2532. The planet gears 2424 operatively mesh with the racks of the teeth 2534. When the shifter 2600 is in its first position as shown in FIG. 28, the firing tube 2530 is held in place by the shifter 2600 and the planet gear 242 is driven by the drive shaft 2410 into the firing tube 2530 and the teeth 2534. It can rotate with respect to the rack. In such a case, the planet gears 2424 rotate about the longitudinal drive axis defined by the drive shaft 2410 and at the same time rotate about the axis defined by their respective gear pins 2423. The reader understands that the planetary gear 2424 is directly driven by the drive shaft 2410 and that the reaction force generated between the planetary gear 2424 and the launch tube 2530 drives and rotates the planetary plate 2421. It should. When the shifter 2600 is actuated to move the clutch key 2602 to its second position, the first lock teeth 2608 disengage from the firing tube 2530 and at the same time, the second lock teeth 2609 form the planet 2421. Engage in When the clutch key 2602 is in its second position, the planet plate 2421 is held in place by the shifter 2600 so that the closure drive is locked out so that the anvil 2230 can be manipulated to move Can not. In such a case, when the drive shaft 2410 is rotated, the output gear 2412 drives the planet gears 2424 and causes the planet gears 2424 to rotate relative to the planet 2421 about their corresponding gear pins 2423. Planetary gear 2424 drives firing tube 2530 via the rack of teeth 2534 to rotate firing tube 2530 about its longitudinal axis.

  In addition to the above, referring to FIG. 23, the firing tube 2530 is operatively coupled to the drive sleeve 2540 of the staple firing system. More specifically, the inner sidewall 2532 of the firing tube 2530 includes a longitudinal slot 2535 defined in the sidewall, which longitudinal slot 2535 fits the longitudinal rib 2545 defined on the drive sleeve 2540. It is configured to receive, such that the drive sleeve 2540 rotates with the firing tube 2530. Drive sleeve 2540 further includes a threaded distal end 2542 threadedly engaged with drive collar 2550. More specifically, drive collar 2550 includes a threaded opening 2552 threadedly engaged with threaded distal end 2542. The drive collar 2550 is positioned within the opening 2228 defined in the housing of the end effector 2200 and is prevented from rotating within the opening 2228, for example by the arrangement of longitudinal ribs and grooves. As a result of the above, rotation of the drive sleeve 2540 causes the drive collar 2550 to translate longitudinally. For example, drive collar 2550 is advanced distally as drive sleeve 2540 is rotated in a first direction and is retracted proximally as drive sleeve 2540 is rotated in a second or opposite direction.

  When drive collar 2550 is pushed distally, as described above, drive collar 2550 pushes staple driver block 2560 and cutting member 2570, eg, a knife, distally during the firing stroke of the staple firing system. More specifically, drive collar 2550 is proximal with staples positioned within staple cavities 2224 defined within cartridge body portion 2222 and cutting member 2570 snapped under the deck surface of cartridge body portion 2222. The staples between the unfired position and the distal firing position where the staples are deformed relative to the anvil 2230 and the tissue captured between the anvil 2230 and the cartridge body portion 2222 is severed by the cutting member 2570 The driver block 2560 and the cutting member 2570 are pushed. The drive collar 2550 includes a drive recess 2554 configured to abut the staple driver block 2560 and the cutting member 2570 when the drive collar 2550 is advanced distally. The staple driver block 2560 includes a plurality of staple cradles defined therein, each staple cradle being configured to support a base of staples. The staple cradles are aligned with the staple cavities 2224 defined in the cartridge body portion 2222 and are arranged in at least two concentric rows.

  The staple driver block 2560 and the cutting member 2570 are attached to the drive collar 2550 so that as the drive collar 2550 moves proximally away from the anvil 2230, the staple driver block 2560 and the cutting member 2570 are proximally moved by the drive collar 2550 It is pulled. In at least one case, staple driver block 2560 and cutting member 2570 include one or more hooks that extend into opening 2557 defined in drive collar 2550. In various examples, the staple driver block 2560 and the cutting member 2570 can be retracted completely back below the deck surface of the cartridge body portion 2222.

  In addition to the above, the end effector 2200 is operable in a third mode of operation in which the clutch key 2602 of the shifter 2600 operatively engages simultaneously the anvil closure system and the staple firing system. In this mode of operation, the first locking tooth 2608 engages the firing tube 2530 of the staple firing system and the second locking tooth 2609 engages the planet 2421 of the transmission 2420. In such a case, the first locking teeth 2608 are positioned in the openings 2538 defined in the firing tube 2530 and the second locking teeth 2609 are the openings 2429 defined in the planet 2421. It is located inside. As a result of the foregoing, drive shaft 2410 simultaneously moves anvil 2230, staple driver block 2560 and cutting member 2570 relative to cartridge body 2222.

  Referring again to FIG. 15, the user of replaceable tool assembly 2000 selects from a kit of second portions 2220, 2220 ', 2220' ', 2220' '' and / or any other suitable second portion. The selected second portion can be assembled to the first portion 2210 of the end effector 2200. Referring primarily to FIG. 18, each second portion includes a housing connector 2229 that engages the housing 2217 of the first portion 2210 when the second portion is assembled to the first portion 2210. In addition, each second portion includes a closure shaft 2440 operatively engaged with the drive socket 2432 of the first portion 2210 when the second portion is assembled to the first portion 2210. Further, each second portion includes a drive sleeve 2540 operatively engaged with the firing tube 2530 of the first portion 2210 when the second portion is assembled to the first portion 2210.

  In addition to the above, referring to FIGS. 35 and 36, the tool assembly 2000 'is interchangeable with the tool assembly 2000. Tool assembly 2000 'is similar to tool assembly 2000 in many respects. However, tool assembly 2000 ′ is configured to provide a circular staple line having a larger diameter than the circular staple line provided by tool assembly 2000. The tool assembly 2000 'includes, inter alia, a wider second portion 2220', a staple driver 2560 ', a knife assembly 2570', a cartridge body 2222 ', and an anvil 2230'. Referring to FIG. 37, tool assembly 2000 ′ ′ is interchangeable with tool assembly 2000. Tool assembly 2000 " is similar to tool assemblies 2000 and 2000 ' in many respects. However, the tool assembly 2000 " is configured to provide a circular staple line having a larger diameter than the circular staple line provided by the tool assembly 2000 '. The tool assembly 2000 "includes, inter alia, a wider second portion 2220", a staple driver 2560 ", a knife assembly 2570", a cartridge body 2222 ", and an anvil 2230". Referring to FIG. 38, the tool assembly 2000 '' 'is interchangeable with the tool assembly 2000. The tool assembly 2000 '' 'is similar in many respects to the tool assemblies 2000, 2000' and 2000 ''. However, the tool assembly 2000 '' 'is configured to provide a circular staple line having a larger diameter than the circular staple line provided by the tool assembly 2000' '. The tool assembly 2000 ′ ′ ′ includes, among other things, a wider second portion 2220 ′ ′ ′, a staple driver 2560 ′ ′ ′, a knife assembly 2570 ′ ′ ′, a cartridge body 2222 ′ ′ ′, and an anvil 2230 ′ ′ ′ Including.

  In various embodiments, in addition to the above, the surgical instrument can have any suitable number of operating modes. In at least one embodiment, the surgical stapling instrument comprises a first operating mode for firing the staples, a second operating mode for deploying the cutting member, and a third for simultaneously firing the staples and deploying the cutting member. And an operation mode. In the first mode of operation, the cutting member is not deployed. Furthermore, the processor of such a surgical instrument can be programmed such that the instrument can not be put into the second mode of operation without first completing the first mode of operation. As a result of the above, the user of the surgical instrument can decide whether to cut tissue after firing the staples.

  An alternative embodiment of a staple cartridge body for use with a surgical stapler is shown in FIG. Cartridge body 2222 ′ includes an annular outer row of staple cavities 2224 and an annular inner row of staple cavities 2224 ′. Staple cavities 2224 are defined in a first stage of the cartridge body deck and staple cavities 2224 'are defined in a second stage of the cartridge body deck. The second stage extends beyond the first stage. In other words, the first stage has a first deck height and the second stage has a second deck height that is higher than the first deck height. A deck wall separates the first and second stages. In various embodiments, the deck wall is sloped. In certain embodiments, the deck wall is orthogonal to the first and / or second stages.

  The cartridge body 2222 'further includes a cavity extension 2229' extending from the first stage of the deck. Cavity extensions 2229 'surround the ends of staple cavity 2224 and extend staple cavity 2224 above the first level. The cavity extension 2229 'can at least partially control the staples above the first stage when the staples are ejected from the staple cavity 2224. The cavity extension 2229 'is also configured to contact and compress tissue captured relative to the cartridge body 2222'. The cavity extension 2229 'can also control tissue flow to the cartridge body 2222'. For example, the cavity extension 2229 'can limit the radial flow of tissue. The cavity extension 2229 'can have any suitable structure and can extend from the first stage by any suitable height. In at least one case, the top surface of the cavity extension 2229 'is, for example, aligned with the second stage or has the same height as the second stage. In other cases, the cavity extension 2229 'can extend up or down the second stage.

  In addition to the above, staple cavities 2224 each include an internally disposed first staple having a first unformed height. The staple cavities 2224 'each include an internally disposed second staple having a second unformed height different from the first unformed height. For example, the first unformed height may be higher than the second unformed height, but the second unformed height may be greater than the first unformed height. In an alternative embodiment, the height of the first green staple and the height of the second green staple are the same.

  The first staple is deformed to a first deformation height and the second staple is deformed to a second deformation height different from the first deformation height. For example, the first deformation height is higher than the second deformation height. Such an arrangement may improve blood flow to the stapled tissue. Alternatively, the second deformation height may be higher than the first deformation height. Such an arrangement may enhance tissue flexibility along the medial transverse cutting line. In certain alternative embodiments, the first deformation height and the second deformation height are the same.

  As mentioned above, the replaceable tool assembly includes, among other things, a shaft, an end effector, and a replaceable staple cartridge. The replaceable staple cartridge staples and severs the tissue captured in the end effector with a closure drive configured to move the open and close the end effector to capture tissue in the end effector And a configured firing drive. When the replaceable staple cartridge is assembled to the shaft, the closure drive and firing drive of the end effector are operatively coupled to the corresponding closure drive and firing drive of the shaft. If the replaceable staple cartridge is not properly assembled to the shaft, the replaceable staple cartridge can not operate in the intended manner. As described in more detail below, the replaceable staple cartridge and / or the shaft is locked against being actuated if the replaceable staple cartridge is not properly attached to the shaft. Can include out.

  Referring now to FIG. 39, the replaceable tool assembly 3000 includes a shaft 3010 and a replaceable staple cartridge 3020. Similar to the above, the replaceable staple cartridge 3020 is operatively coupled to the closure drive output and the firing drive output, respectively, when the staple cartridge 3020 is fully seated on the shaft 3010. And a launch drive input. The operation of such a closure and launch system is not repeated here for the sake of brevity.

  The replaceable tool assembly 3000 further includes a lockout circuit 3090. Lockout circuit 3090 includes a conductor 3096 and a contact 3092. The first contact 3092 is electrically coupled to the first conductor 3096, and the second contact 3092 is electrically coupled to the second conductor 3096. The first contact 3092 is not electrically coupled to the second contact 3092 until the staple cartridge 3020 is fully seated on the shaft 3010. Staple cartridge 3020 includes a contact bridge 3094 that engages and electrically couples with contact 3092 when staple cartridge 3020 is fully seated on shaft 3010. The contacts 3092 and the contact bridge 3094 are configured and arranged such that the contact bridge 3094 does not electrically couple the contacts 3092 when the staple cartridge 3020 is only partially seated on the shaft 3010.

  The replaceable tool assembly 3000 can be used, for example, with a surgical instrument system that includes a manually operable handle and / or a robotic system. In various embodiments, the surgical instrument system includes a controller configured to operate the electric motor in addition to the electric motor configured to drive the staple firing system of the tool assembly 3000. The lockout circuit of tool assembly 3000 communicates with the controller. When the controller detects that the contact bridge 3094 is not engaged to the contact 3092 or that the lockout circuit is open, the controller prevents the electric motor from operating the staple firing system. In various examples, the controller is configured to not supply power to the electric motor when the lockout circuit is open. In certain other cases, the controller supplies power to the electric motor so that when the lockout circuit is open, the electric motor can activate the closure system but can not activate the launch system. Configured to In at least one such example, the controller activates a transmission coupled to the electric motor to direct the output of the electric motor only to the closure system. When the controller detects that the contact bridge 3094 is engaged to the contact 3092 or that the lockout circuit is closed, the controller enables the electric motor to operate the staple firing system.

  In addition to the above, when the surgical instrument system includes a handle, when the controller detects that the lockout circuit is in the open configuration, the controller actuates a trigger lock that prevents the firing trigger of the handle from being actuated. be able to. Once the staple cartridge 3020 is fully seated on the shaft 3010 and the lockout circuit is closed, the controller can retract the trigger lock to allow actuation of the firing trigger. Such systems can be utilized with motorized and / or non-motorized launch drives. The non-motorized launch drive can, for example, be driven by a manual crank.

  As mentioned above, the anvil 2230 may be assembled to the trocar shaft 2450 of the closure drive of the tool assembly 2000. The connecting flange 2238 of the anvil 2230 is configured to engage a recess 2458 defined in the trocar shaft 2450 for connecting the anvil 2230 thereto. Once the anvil 2230 is assembled to the trocar shaft 2450, the closure drive may retract or pull the trocar shaft 2450 and anvil 2230 towards the staple cartridge 2222 to compress the tissue against the staple cartridge 2222. However, in some cases, the anvil 2230 may not be properly assembled to the trocar shaft 2450. A misassembly of the anvil 2230 with respect to the trocar shaft 2450 can often occur when the trocar shaft 2450 does not extend sufficiently above the deck of the staple cartridge 2222 when the physician attempts to assemble the anvil 2230 onto the trocar shaft 2450. Usually, in such a case, the anvil 2230 is fully attached to the trocar shaft 2450 so that the trocar shaft 2450 can move the anvil 2230 towards the staple cartridge 2222 but the anvil 2230 does not The anvil 2230 can disengage from the trocar shaft 2450 as it begins to compress against the staple cartridge 2222.

  Referring now to FIGS. 39 and 40, a replaceable tool assembly 3100 is shown that is similar in many respects to the replaceable tool assembly 2000 described above. Tool assembly 2000 includes a cartridge body 3120 that includes a deck 3121 configured to support tissue when tissue is compressed against cartridge body 3120 by anvil 2130. The tool assembly 3100 further includes a closure drive configured to move the anvil 2130 relative to the cartridge body 3120. The closure drive includes a trocar shaft 3150 having a recess formed therein as described above. The recess includes a distal shoulder 3158 configured to hold the anvil 2130 against the trocar shaft 3150. In addition, the tool assembly 3100 further includes a firing drive configured to eject the staples from the cartridge body 3120. The firing drive includes a rotatable shaft 3162 and a translatable collar 3160 threadably engaged with the rotatable shaft 3162, the rotatable shaft 3162 ejecting staples from the cartridge body 3120. Is configured as. The rotatable shaft 3162 includes a longitudinal opening 3164 defined therein and a trocar shaft 3150 extending through the opening 3164.

  In addition to the above, the closure drive further includes a clip 3190 attached to the trocar shaft 3150. Clip 3190 includes a base 3192 mounted in a slot defined in trocar shaft 3150. The clip 3190 further includes a flexible arm or appendage 3198 extending from the base 3192. The arm 3198 is movable between an extended position (FIG. 39) and a deflected position (FIG. 40). When the arms 3198 are in their deflected position, the anvil 2130 can be locked relative to the trocar shaft 3150 as illustrated in FIG. The arms 3198 are held in their deflected position by the translatable collar 3160 of the firing drive when the trocar shaft 3150 extends sufficiently above the deck 3121 of the cartridge body 3120 as illustrated in FIG. Ru. Translatable collar 3160 includes an annular shoulder 3168 that resiliently biases arm 3198 inwardly when arm 3198 contacts shoulder 3168. It is configured.

  If the trocar shaft 3150 is not in a fully extended position above the cartridge deck 3121, the arm 3198 is not biased inwardly by the shoulder 3168. In such a case, as illustrated in FIG. 39, the arms 3198 are in their extended position. When the arms 3198 are in their extended position, the arms 3198 prevent the anvil 2130 from being attached to the trocar shaft 3150. More specifically, the arms 3198 prevent the connecting flange 2138 of the anvil 2130 from seating behind the shoulder 3158 defined within the trocar shaft 3150. In such a case, the arm 3198 prevents the anvil 2130 from being partially attached to the trocar shaft 3150, so that the physician who is trying to assemble the anvil 2130 to the trocar shaft 3150 can It can not be partially assembled to the 3150, and the problems described above can be avoided. The reader should understand that the anvil 2130 is often assembled to the trocar shaft 3150 in situ or within the patient's body, and proper assembly of the anvil 2130 to the trocar shaft 3150 will accelerate the completion of the surgical procedure being used. It is. The system described above provides a lockout that prevents the partially assembled anvil from being compressed against the tissue.

  Referring now to FIGS. 41-43, the replaceable tool assembly 3200 is configured as a lockout that prevents the closure drive from retracting unless the anvil is attached to the closure drive, as described in detail below. including. Tool assembly 3200 includes a shaft 3210 and an end effector 3220. End effector 3220 includes an outer housing 3227, a cartridge body 3222, and a longitudinal opening 3226 defined through cartridge body 3222. Tool assembly 3200 further includes a closure drive that includes a trocar shaft 3250 and an anvil 3230 attachable to trocar shaft 3250. Similar to the above, the closure drive is configured to move the anvil 3230 towards or away from the cartridge body 3222. The trocar shaft 3250 is movable between an extended position and a retracted position. FIGS. 42 and 43 both show the trocar shaft 3250 in the extended position.

  In addition to the above, tool assembly 3200 prevents trocar shaft 3250 from moving from its extended position (FIGS. 42 and 43) towards its retracted position when anvil 3230 is not assembled to trocar shaft 3250. It further includes a retraction lock 3290 configured as described above. Retraction lock 3290 includes a lock arm 3292 rotatably mounted to housing 3227 about projection (or pin) 3294. Retraction lock 3290 further includes a spring 3296 engaged with lock arm 3292, which is configured to bias lock arm 3292 toward trocar shaft 3250. The trocar shaft 3250 includes a locking shoulder 3258 and when the anvil 3230 is not assembled to the trocar shaft 3250 as shown in FIG. 42, the locking arm 3292 is hooked on the locking shoulder 3258 to It is configured to prevent the shaft 3250 from moving proximally. More specifically, the locking arm 3292 includes a pawl 3298 configured to slide under the locking shoulder 3258. When the anvil 3230 is assembled to the trocar shaft 3250, the anvil 3230 contacts the lock arm 3292 and shifts the lock arm 3292 away from the locking shoulder 3258, as illustrated in FIG. At that point, the trocar shaft 3250 can be unlocked and moved towards the cartridge body 3222 to its retracted position.

  Referring now to FIGS. 44-46, the replaceable tool assembly 3300 includes a closure drive, a staple firing drive, and an anvil of the closure drive suitable for tissue clearance, as described in more detail below. And a lockout configured to prevent operation of the staple firing drive until it is positioned at Tool assembly 3300 includes a shaft 3310 and an end effector 3320. End effector 3320 includes an inner frame 3329, an outer housing 3327, and a cartridge body 3322. As above, the closure drive includes a trocar shaft 3350 and an anvil 2230 attachable to the trocar shaft 3350. Further, as described above, the trocar shaft 3350 is between the extended position (FIG. 45) and the retracted position (FIG. 46) so as to move the anvil 2230 toward or away from the cartridge body 3322. It is movable. The firing drive includes a rotatable shaft 3360 configured to offset the firing drive distally to eject the staples stored within the cartridge body 3322.

  In addition to the above, the end effector 3320 includes a firing drive lock 3390 movably mounted to the inner frame 3329. Launch drive lock 3390 includes a lock pin 3394 and a lock spring 3398 positioned around lock pin 3394. The lock pin 3394 includes a head 3392 and a stop 3396. The locking spring 3398 is located intermediate the stop 3396 and the sidewall 3328 of the cavity defined in the inner frame 3329. When the trocar shaft 3350 is in the extended position, as shown in FIG. 45, the lock spring 3398 biases the lock pin 3394 to lock opening 3364 defined in the rotatable shaft 3360 of the staple firing drive. Put in In such a case, the interaction between the lock pin 3394 and the side wall 3364 of the lock opening prevents the shaft 3360 from rotating and firing staples from the cartridge body 3322. When trocar shaft 3350 is fully retracted, trocar shaft 3350 engages head 3392 of lock pin 3394. Head 3392 is configured on head 3392 configured to be engaged by trocar shaft 3350 to move firing drive lock 3390 between the locking configuration (FIG. 45) and the unlocking configuration (FIG. 46). Including a cam surface defined in When drive lock 3390 is in its unlocked configuration, the shaft 3360 of the firing drive can rotate.

  Locking out the firing drive of the tool assembly 3300 before moving the staples requires moving the anvil 2230 to or within a predetermined position. Furthermore, to lock out the firing drive of the tool assembly 3300 before allowing the staples to be fired, the tissue clearance between the anvil 2230 and the cartridge body 3322 needs to be less than a certain distance is there. As a result, the position of the anvil 2230 and / or the closure system releases the staple firing lockout. Such a configuration may, among other things, help to prevent staple malformation and / or poor tissue compression.

  Referring now to FIGS. 47-49, the replaceable tool assembly 3400 includes a closure drive configured to clamp tissue, a staple firing drive, and a clamp pressure sufficient for the closure drive to tissue. And a firing drive lockout 3490 configured to prevent the staple firing drive from operating prior to applying the. The closure drive includes a trocar shaft 3450 and an anvil, such as an anvil 2230, attached to the trocar shaft 3450. Further, as described above, trocar shaft 3450 is movable between an extended position (FIG. 48) and a retracted position (FIG. 49) to compress tissue relative to the cartridge body of tool assembly 3400. The firing drive includes a rotatable shaft 3460 configured to offset the staple driver distally to eject the staples from the cartridge body.

  The firing drive lockout 3490 is located intermediate the trocar shaft 3450 of the closure drive and the rotatable shaft 3460 of the firing drive. The firing drive lockout 3490 includes a distal plate 3492, a proximal plate 3494, and a spring 3493 located intermediate the distal plate 3492 and the proximal plate 3494. The firing drive lockout 3490 further includes a lock pin 3498, which locks the lock pin 3498 into engagement with the shaft 3460 (FIG. 48) and disengages the lock pin 3498 with the shaft 3460. It is movable between the unlocked configuration (FIG. 49). Locking pin 3498 is positioned within pin chamber 3496 defined between distal plate 3492 and proximal plate 3494. More specifically, the lock pin 3498 includes a beveled head located intermediate the cam 3495 defined on the distal plate 3492 and the cam 3495 defined on the proximal plate 3494. As the trocar shaft 3450 retracts proximally, the trocar shaft 3450 pushes the distal plate 3492 proximally and the cam 3495 defined on the distal plate 3492 engages the head of the lock pin 3498. In such case, as illustrated in FIG. 49, the cam 3495 defined on the distal plate 3492 cooperates with the cam 3495 defined on the proximal plate 3494 to lock pin 3498 Shift to unlocked configuration.

  As described above, the cams 3495 of the firing drive lockout 3490 squeeze the head of the lock pin 3498 as the distal plate 3492 is moved by the trocar shaft 3450 towards the proximal plate 3494. More specifically, cam 3495 drives lock pin 3498 inwardly and out of engagement with rotatable shaft 3460. When the locking pin 3498 is in its locking configuration, the locking pin 3498 is positioned within the locking opening 3468 defined in the shaft 3460 and due to the interaction between the locking pin 3498 and the side wall 3468 of the locking opening Lock pin 3498 prevents shaft 3460 from rotating. As a result, the staples can not be fired from the cartridge body by the firing drive. When the lock pin 3498 is moved to the unlocked configuration, as described above, the lock pin 3498 disengages from the lock opening and the shaft 3460 can be rotated by the firing drive to cause the staples to be fired from the cartridge body. In various embodiments, the shaft 3460 can include a circumferential array of lock openings 3468 defined in the shaft 3460, each lock opening 3468 receiving a lock pin 3498 to lock the firing drive It is configured to go out. Referring again to FIGS. 49-51, the firing drive lockout 3490 further includes a biasing member, such as, for example, a spring 3499, configured to bias the lock pin 3498 into the locking opening 3468.

  In addition to the above, spring 3493 of firing drive lockout 3490 is configured to resist proximal movement of trocar shaft 3450. The spring 3493 is a linear coil spring, but any suitable spring can be used. Furthermore, more than one spring can be used. In any event, the spring 3493, or spring system, has a stiffness that applies a spring force to the distal plate 3492 of the firing drive lockout 3490 when the trocar shaft 3450 is retracted. In other words, the force exerted on the distal plate 3492 by the spring 3493 increases in proportion to the distance the trocar shaft 3450 is displaced proximally. The spring force produced by spring 3493 opposes the clamping force that anvil 2230 applies to the tissue. As a result, in order to fully offset the distal plate 3492 to unlock the firing drive, the clamping force must overcome the constant or predetermined spring force that the spring 3493 causes. In such a case, the firing drive lockout 3490 can be released and the tissue clamping force needs to meet a predetermined threshold before the staple firing drive can be actuated.

  As discussed in connection with the various embodiments disclosed herein, the staple firing drive drives the staples against the anvil to deform the staples to a desired formed height. In various examples, the staple firing drive is also configured to push a cutting member, such as, for example, a knife, distally to cut tissue captured between the cartridge body and the anvil. In such a case, the knife is exposed above the deck of the cartridge body. However, when the anvil is in the closed (or clamped) position, the anvil is positioned in close relation to the cartridge body so that the majority of the knife is covered by the anvil even if the knife is exposed above the cartridge body . If the anvil is moved to its open position and / or removed from the closure drive before the knife retracts below the deck of the cartridge body, the knife will not be covered and will be exposed. FIGS. 52-54 illustrate a tool assembly 3500 including a lockout 3590 configured to prevent the anvil from moving to its open position while the knife is exposed above the cartridge deck. There is.

  Tool assembly 3500 includes a closure drive and a firing drive. The closure drive includes a trocar shaft 3550 and an anvil 3530 removably attachable to the trocar shaft 3550. As above, the trocar shaft 3550 is translatable proximally and distally by a rotatable closure shaft 2440 threadedly engaged with the trocar shaft 3550. The firing drive includes a rotatable shaft 3562 and a translatable collar 3560 threadably engaged with the rotatable shaft 3562. Similar to the above, the collar 3560 can be translated proximally and distally, respectively, as the shaft 3562 rotates in the first and second directions. Further, as described above, the collar 3560 of the firing drive is configured to advance and retract the array of staple drivers and the knife assembly 2570 towards or away from the anvil 3530.

  In addition to the above, the lockout 3590 includes a lock arm 3592 rotatably mounted on the shaft 3562 of the firing drive for pivoting about a pivot 3594. The lockout 3590 further includes a biasing member (or spring) 3599 engaged with the locking arm 3592 which is configured to bias the locking arm 3592 into contact with the anvil 3530 . In use, after assembling the anvil 3530 to the trocar shaft 3550, the trocar shaft 3550 is retracted to position the anvil 3530 in its closed (or clamped) position relative to the cartridge body. When the anvil 3530 is retracted, the lock arm 3592 of the lockout 3590 slides against the outer surface of the anvil 3530 until the lock arm 3592 aligns with the lock recess 3532 defined in the anvil 3530. At that time, as shown in FIG. 53, a spring 3599 biases the lock arm 3592 into the lock recess 3532. More specifically, locking arm 3592 is positioned behind the locking shoulder that defines locking recess 3532. The firing drive can then be actuated to fire the staples and cut the tissue. In such a case, the cutting edge of the knife assembly 2570 is exposed above the cartridge body and the closure drive is locked out or opened until the cutting edge of the knife assembly 2570 is not exposed by the lockout 3590 It is supposed not to be.

  Referring mainly to FIG. 52, the lock arm 3592 further includes a reset tab 3593 extending therefrom. The collar 3560 of the firing drive further includes a cam 3563 configured to engage the reset tab 3593 when the firing drive causes the collar 3560 and the knife assembly 2570 to retract proximally. The cam 3563 is configured to rotate the lock arm 3592 downward to disengage the lock shoulder defined in the lock recess 3532 and unlock the closure drive. The cam 3563 is configured to unlock the closure drive when the cutting edge of the knife assembly 2570 is retracted below the cartridge deck. However, in one embodiment, the cam 3563 can unlock the closure drive when the cutting edge is flush or at least substantially flush with the cartridge deck. In some embodiments, the closure drive may not be unlocked until the knife assembly 2570 is fully retracted. Once the closure drive is unlocked, the closure drive can be actuated to move the anvil 3530 back to the open (or unclamped) position.

  According to various embodiments, once the staples of the replaceable tool assembly are fired, the tool assembly can not be reused. As described in more detail below, the tool assembly may include a lockout configured to prevent the tool assembly from re-clamping on tissue after the tool assembly is used to staple tissue. .

  In at least one embodiment, with reference to FIGS. 53-56, the replaceable tool assembly 3600 may, for example, be a closure driver configured to position an anvil, such as an anvil 2230, relative to a staple cartridge; And a launch drive configured to drive from. As above, the anvil 2230 is attachable to the translatable trocar shaft 3650 of the closure drive. Further, as before, the firing drive comprises a rotatable shaft 3660, a translatable collar 2550 threadably engaged with the rotatable shaft 3660, and a staple firing driver displaceable by the rotatable shaft 3660 And 2560. In use, the closure drive is operable to position the anvil 2230 in a clamped position relative to the staple cartridge, and the firing driver is then inserted into the tissue captured between the anvil 2230 and the staple cartridge It is operable to fire the staples. The closure drive is then actuated to open the anvil 2230 and release the tissue.

  In addition to the above, tool assembly 3600 includes lockout 3690 configured to prevent anvil 2230 from being re-clamped onto tissue. The lockout 3690 includes a lock arm 3692 rotatably mounted on a rotatable shaft 3660, the lock arm 3692 being in a non-clamping position (FIG. 53) with the closure driver opening the anvil 2230 and a closed clamping position (FIG. 53) Fig. 54) is held in the unlocked configuration by the firing drive when moving between. When the trocar shaft 3650 and anvil 2230 move relative to the firing drive to position the anvil 2230 relative to the staple cartridge, the locking arm 3692 locks its lock between the rotatable shaft 3660 and the translatable collar 2550. It is held in the release configuration. As illustrated in FIG. 55, the arm 3692 is held in its unlocked configuration until the firing drive is actuated. As the shaft 3460 rotates in a first direction, the collar 2550 is displaced distally and the spring 3699 of the lockout 3690 can bias the lock arm 3692 against the trocar shaft 3650. As the collar 2550 is displaced distally to fire the staples and then retracted proximally, the trocar shaft 3650 rotates relative to the lock arm 3692. The closure drive can then be actuated to reopen the anvil 2230 to unclamp tissue and / or remove the anvil 2230 from the trocar shaft 3650. When the anvil 2230 is reopened, the spring 3699 biases the locking arm 3692 into the locking recess 3652 defined within the trocar shaft 3650 and / or the anvil 2230. When the locking arm 3692 is positioned within the locking recess 3652, the locking arm 3692 prevents the trocar shaft 3650 from retracting proximally. When operating the closure drive to retract trocar shaft 3650, lock arm 3692 abuts the locking shoulder defined in locking recess 3652 to prevent retraction of trocar shaft 3650 and anvil 2230. Do. As a result, again using the tool assembly 3600 as the lockout 3690 prevents the anvil 2230 from re-clamping on tissue after the tool assembly 3600 has finished or at least partially completed the firing cycle. I can not do it. Additionally, lockout 3690 can function as a used cartridge lockout.

  59 and 60, tool assembly 3700 includes staple cartridge 3720 and anvil 3730. As shown in FIG. The tool assembly 3700 is configured to eject (or fire) the staples removably stored in the staple cartridge 3720, as well as the closure system configured to move the anvil 3730 towards the staple cartridge 3720. Further includes a launch system. The anvil 3730 includes a longitudinal shaft portion 3736 and a mounting arm 3738 extending from the shaft portion 3736, which mounting arm 3738 is adapted to resiliently grip the closure actuator (or trocar) 3734 of the closure system. It is configured. The closure actuator 3734 can be retracted proximally by a closure drive that moves the trocar 3734 between the open non-clamping position (FIG. 59) and the closed clamping position (FIG. 60). As described in more detail below, when the closure system is in its open configuration as illustrated in FIG. 59, the staple firing system is disabled and activated to fire the staples stored within the staple cartridge 3720. I can not do it.

  In addition to the above, the staple firing system includes a threaded aperture configured to receive the threaded distal end of the firing shaft 3750, as well as a rotatable firing shaft 3750 that includes the threaded distal end. Includes a translatable firing nut 2550 that includes a portion. Notably, with reference to FIG. 59, between the threaded distal end of firing shaft 3750 and the threaded opening defined in firing nut 2550 when anvil 3730 is in its open position. There is a gap in the. As a result, the firing shaft 3750 can not displace the firing nut 2550 distally until the firing shaft 3750 is threadingly engaged with the firing nut 2550.

  As illustrated in FIG. 60, the mounting arm 3738 of the anvil 3730 is configured to engage the firing shaft 3750 and flex the firing shaft 3750 outward when the anvil 3730 is moved to its closed position. Ru. Referring mainly to FIGS. 59A and 60A, the mounting arm 3738 engages with the inwardly extending projection 3758 defined on the firing shaft 3750 and out the projection 3758 of the firing shaft 3750 and its surroundings. It is configured to push in the direction. In such a case, the threaded distal end of the firing shaft 3750 is pushed into operative engagement with the threaded opening of the firing nut 2550 at the threaded interface 3790 at that point When the firing shaft 3750 is rotated by the firing drive, the firing shaft 3750 can displace the firing nut 2550 distally and eject the staples from the staple cartridge 3720. When anvil 3730 is reopened, firing shaft 3750 returns to its original configuration and is operatively disengaged from firing nut 2550.

  As a result of the above, the tool assembly 3700 can be used if the anvil 3730 is not attached to the closure system, if the anvil 3730 is improperly attached to the closure system, and / or if the anvil 3730 is not fully closed. Includes a lockout that prevents the staples from being fired.

  61 and 62, the tool assembly 3800 includes a replaceable staple cartridge with staples removably stored therein, an anvil configured to deform the staples, and an anvil staple cartridge. And a firing system configured to cause the staples to be ejected from the staple cartridge. As described below, the tool assembly 3800 further includes a lockout configured to prevent actuation of the firing system if the staple cartridge is not fully seated on the tool assembly 3800.

  The staple cartridge includes a cartridge frame 3820 configured to engage with the shaft frame 3810 of the tool assembly 3800. The staple cartridge further includes a drive shaft 3830 that is inserted into the shaft frame 3810 when the staple cartridge is assembled to the tool assembly 3800. More specifically, referring mainly to FIG. 64, drive shaft 3830 includes a proximal end 3832 including an annular gear portion 3833 which is configured when the staple cartridge is assembled to tool assembly 3800. And is configured to engage and squeeze the transmission 3860 of the launch system. Referring mainly to FIG. 62, the transmission 3860 includes a first portion 3862, a second portion 3864 and a third portion 3868, which are operatively engaged with one another when pressed, Rotational input motion can be transmitted to drive shaft 3830.

  Referring primarily to FIGS. 63 and 64, the annular gear portion 3833 of the drive shaft 3830 is configured to engage a corresponding gear portion 3863 defined distally of the first transmission portion 3862, The first transmission portion 3862 can be operatively engaged with the second transmission portion 3864 when the first transmission portion 3862 is pushed proximally by the drive shaft 3830. More specifically, the first transmission portion 3862 includes a proximal gear portion 3685, which is configured to move the first transmission portion 3862 proximally by the drive shaft 3830. At the same time as it engages the distal gear portion 3866 of the two gearing portion 3864, it pushes the second gearing portion 3864 proximally. When the second transmission portion 3864 is pushed proximally by the first transmission portion 3862, the second transmission portion 3864 is operatively engaged with the third transmission portion 3868, as described above. be able to. More specifically, the second transmission part 3862 comprises a proximal gear part 3867 which comprises a first transmission part 3862 and a second transmission part 3864 by means of a drive shaft 3830. When pushed proximally, it engages with the distal gear portion 3869 of the third transmission portion 3864. The third transmission portion 3868 is operatively coupled to the input shaft and is supported by the input shaft and / or shaft housing 3810 against proximal displacement.

  Referring mainly to FIG. 61, the transmission 3860 further includes at least one spring member 3870 located intermediate the first transmission portion 3862 and the second transmission portion 3864. In at least one case, the spring member 3870 can include, for example, one or more wave springs. The spring member 3870 is configured to bias the first transmission portion 3862 and the second transmission portion 3864 apart from one another. Additionally or alternatively, the transmission 3860 further includes at least one spring member 3870 located intermediate the second transmission portion 3864 and the third transmission portion 3868, the spring member 3870 Are configured to bias the second transmission portion 3864 and the third transmission portion 3868 apart from one another, as described above. Referring primarily to FIG. 65, each spring member 3870 includes two disc springs 3872 configured to flex when a compressive force is applied thereto. However, spring member 3870 may include any suitable configuration.

  In addition to the above, referring again to FIG. 61, the input shaft of the tool assembly 3800 can rotate the third transmission portion 3868. However, a spring member 3870 located intermediate the second transmission portion 3864 and the third transmission portion 3868 will move the proximal gear portion 3867 of the second transmission portion 3864 to the third transmission portion 3868. The rotation of the third transmission portion 3868 can not be transmitted to the second transmission portion 3864 unless compressed sufficiently to connect with the distal gear portion 3869. Similarly, a spring member 3870 located intermediate the first transmission portion 3862 and the second transmission portion 3864 comprises the proximal gear portion 3865 and the second transmission portion 3864 of the first transmission portion 3862. The second transmission portion 3864 can not be transmitted to the first transmission portion 3862 unless it is compressed sufficiently to connect with the distal gear portion 3866. As mentioned above, when the staple cartridge is fully seated on the shaft frame 3810, the drive shaft 3830 engages the first transmission portion 3862 and the second transmission portion 3864 as illustrated in FIG. And engage the second transmission portion 3864 and the third transmission portion 3868. In such case, the rotation of the input shaft may be transmitted to the drive shaft 3830. However, when the staple cartridge is not fully seated on the shaft frame 3810, one or more of the transmission portions 3862, 3864, and 3868 are not operatively engaged with one another and rotation of the input shaft is the drive shaft 3830. It can not be transmitted to As such, the tool assembly 3800 ensures that the staples stored in the staple cartridge can not be ejected from the staple cartridge unless the staple cartridge is fully seated on the shaft frame 3810.

  Referring now to FIGS. 66-68, tool assembly 3900 includes a shaft 3910 and a replaceable staple cartridge 3920. The replaceable staple cartridge 3920 is configured to eject the staples removably stored in the staple cartridge 3920, as well as the closure drive configured to move the anvil relative to the staple cartridge 3920. Includes a firing drive that includes a rotatable firing shaft 3930. As above, the tool assembly 3900 is configured to prevent the firing drive from firing the staples out of the staple cartridge 3920 unless the staple cartridge 3920 is fully or fully seated on the shaft 3910 Including out. More specifically, lockout prevents the firing shaft 3930 from rotating within the staple cartridge 3920 unless the staple cartridge 3920 is fully or fully seated on the shaft 3910. In various examples, referring to FIG. 67, the firing shaft 3930 includes an annular array of locking openings 3939 defined in the outer periphery of the firing shaft 3930 and the staple cartridge 3920 includes locking openings 3939 defined in the shaft 3930. , And at least one lock 3929 configured to releasably engage the. Locking portion 3929 includes a proximally extending cantilever but any suitable configuration may be used. The locking portion 3929 further includes a locking protrusion that extends into the locking opening 3939 to allow the firing shaft 3930 to rotate or at least substantially rotate relative to the body of the staple cartridge 3920. To prevent. The locking portion 3929 is, as illustrated in FIG. 68, the firing shaft 3930 until the locking portion 3929 is lifted and disengaged from the locking opening 3939 when the staple cartridge 3920 is fully or fully assembled to the shaft 3910. It is configured to be biased into lock opening 3939 defined therein. Referring to FIG. 68, the outer housing of shaft 3910 includes barbs 3919 configured to lift lock 3929 away from firing shaft 3930 to cause lock 3929 to disengage from lock opening 3939. It is. The collar 3919 is configured to prevent the locking portion 3929 from disengaging from the firing shaft 3930 after the staple cartridge 3920 is fully or fully seated on the shaft 3910 as illustrated in FIG. It is done. FIG. 67 illustrates a scenario where the staple cartridge 3920 is not fully or fully seated on the shaft 3910.

  Referring now to FIGS. 69-71, tool assembly 4000 includes a shaft 4010 and a replaceable staple cartridge 4020. The replaceable staple cartridge 4020 is configured to eject staples removably stored in the staple cartridge 4020, in addition to a closure drive configured to move the anvil relative to the staple cartridge 4020. Includes a firing drive that includes a rotatable firing shaft 3930. Staple cartridge 4020 includes a lock 4029 configured to removably connect staple cartridge 4020 to shaft 4010. The lock 4029 includes a proximally extending cantilever and a locking shoulder 4028 extending therefrom. The lock 4029 flexes inwardly within the shaft 4010 when the staple cartridge 4020 is assembled to the shaft 4010, and then the locking shoulder 4028 of the lock 4029 is defined in the outer housing of the shaft 4010. When aligned with the window 4019, it is configured to resiliently return to its non-flexing state, or at least toward the non-flexing state. In such a case, as illustrated in FIG. 70, the locking shoulder 4028 penetrates the window 4019 when the staple cartridge 4020 is completely or fully seated on the shaft 4010. To unlock the staple cartridge 4020, the physician may, for example, insert the tool or his / her finger into the window and depress the lock 4029 away from the window 4019. At that point, the staple cartridge 4020 can be removed from the shaft 4010 and a new staple cartridge can be attached to the shaft 4010 if the physician desires.

  In addition to or in place of the above, the surgical stapling system requires that the closure drive of the stapling system be closed when the staple cartridge is not fully or fully seated on the shaft of the stapling system. It may include an electrical lockout configured to prevent clamping of the anvil onto tissue and / or to prevent the firing drive from performing its firing stroke. In various examples, the stapling system is configured to operate the firing drive in addition to a sensor configured to detect whether the staple cartridge has completely or fully seated on the shaft. Can include an electric motor. If the sensor detects that the staple cartridge is not fully or fully attached to the shaft, the motor can be electrically shut off. In various examples, the stapling system includes a controller, such as a microprocessor, in communication with the sensor and the electric motor. In at least one case, the controller may, on the one hand, activate the electric motor when the sensor detects a staple cartridge properly seated on the shaft and, on the other hand, on the shaft, When the sensor detects a properly seated staple cartridge, the electric motor is not operated.

  Referring now to FIG. 72, the tool assembly kit 4100 includes a shaft 4110 and a plurality of staple cartridges, such as 4120, 4120 ', 4120 ", and 4120"'. Each staple cartridge 4120, 4120 ', 4120 ", and 4120"' is configured to provide a circular array of staples having different diameters. For example, staple cartridge 4120 "'is configured to apply staples in a pattern having a large diameter, and staple cartridge 4120 is configured to apply staples in a pattern having a small diameter. In various examples, different staple cartridges can deploy staples having different unformed heights. In at least one case, a staple cartridge that applies staples in a larger pattern deploys staples with a larger undeformed height, while a staple cartridge that applies staples in a smaller pattern has a smaller undeformed height Deploy the staples with In some cases, the staple cartridge can deploy staples having two or more unformed heights. In any case, a staple cartridge selected from a plurality of staple cartridges can be assembled to the shaft 4110.

  Referring to FIGS. 72 and 73, the tool assembly 4100 includes detection circuitry 4190 configured to detect whether the staple cartridge has been fully or fully attached to the shaft 4110. The detection circuit 4190 is not completely housed within the shaft 4110, but rather requires that the staple cartridge be properly assembled to the shaft 4110 in order to complete the detection circuit 4190. The detection circuit 4190 includes a conductor 4193 extending through the passageway 4192 defined in the frame of the shaft 4110 and / or along the outer housing of the shaft 4110. Referring mainly to FIG. 73, each conductor 4193 is electrically coupled with an electrical contact 4194 defined at the distal end of the housing. The staple cartridge 4120 includes, for example, corresponding electrical contacts 4195, which are positioned and arranged on the body 4122 of the staple cartridge 4120 such that the contacts 4195 engage the contacts 4194 on the shaft 4110. Ru. Staple cartridge 4120 further includes a conductor 4196 extending through and / or along cartridge body 4122. Each conductor 4196 is electrically coupled to contact 4195. In some cases, conductors 4196 are directly coupled to one another, in which case detection circuit 4190 is closed when staple cartridge 4120 is properly assembled to shaft 4110.

  In some cases, further to the above, the detection circuit 4190 of the tool assembly 4100 extends through the deck portion 4124 of the staple cartridge 4120. In at least one case, the deck portion 4124 is movably attached to the cartridge body 4122. More specifically, in at least one such case, a spring member 4198 is positioned intermediate the cartridge body 4122 and the deck portion 4124. The spring member 4198 is configured to allow the deck portion 4124 to move or float relative to the cartridge body 4122 when the tissue is compressed relative to the deck portion 4124. In at least one case, the spring member 4198 may include, for example, one or more wave springs. Also, the spring member 4198 forms a conductive path between the cartridge body 4122 and the deck 4124. More specifically, spring member 4198 is located intermediate electrical contacts 4197 and 4199 defined in cartridge body 4122 and deck portion 4124, respectively. The conductor 4196 is electrically coupled to an electrical contact 4197 defined at the distal end of the cartridge body 4122, and the electrical contact 4199 is electrically coupled to each other via the conductor in the deck portion 4125. As mentioned above, the detection circuit 4190 is closed when the staple cartridge 4120 is properly assembled to the shaft 4110.

  Referring now to FIGS. 74-76, the tool assembly 4200 is configured to prevent the replaceable circular staple cartridge from being fired more than once as described in more detail below. Contains. In use, the replaceable circular staple cartridge 4220 is assembled to the shaft 4210 of the tool assembly 4200. Next, the tool assembly 4200 is positioned at the surgical site and the anvil 2230 is assembled to the trocar 2450 of the closure drive. Next, the closure drive is used to move the anvil 2230 toward the staple cartridge 4220 until the anvil 2230 reaches the closed (or clamped) position, thereby clamping the patient's tissue against the staple cartridge 4220. The position of the anvil 2230 is illustrated in FIG. At that point, the firing drive can be activated to deploy the staples removably stored within the staple cartridge 4220. The firing drive includes, among other things, a staple firing driver 2560 as well as a rotatable drive shaft 4230 screwed into the drive collar 4240. While the drive collar 4240 and the firing driver 2560 comprise separate components, in alternative embodiments the drive collar 4240 and the firing driver 2560 may be integrally formed. The firing drive forces the drive collar 4240 and the staple firing driver 2560 distally between the unfired position (FIG. 74) and the firing position (FIG. 75) during the firing stroke to eject the staples from the staple cartridge 4220 It can rotate in the direction of 1. As drive collar 4240 and staple driver 2560 are prevented from rotating within staple cartridge 4220, as a result, drive shaft 4230 rotates relative to drive collar 4240 and staple driver 2560.

  In addition to the above, the drive collar 4240 includes one or more lockouts 4290 extending proximally therefrom. Each lockout 4290 includes a lockout pin 4292 slidably positioned within a pin opening 4293 defined in the drive collar 4240. Each lockout 4290 further includes a biasing member, such as, for example, a spring 4294, configured to bias pin 4292 proximally. When the firing drive is in its unfired configuration as illustrated in FIG. 74, the lockout 4290 does not engage the rotatable drive shaft 4230 and / or the frame 4222 of the staple cartridge 4220. When drive collar 4240 and staple driver 2560 are pushed distally by drive shaft 4230, lockout pin 4922 moves away from drive shaft 4230 as illustrated in FIG. Once the firing stroke is complete and the staples are fully deformed relative to the anvil 2230, the drive shaft 4230 is rotated in the opposite direction to pull the drive collar 4240 and the staple driver 4260 proximally during the retraction stroke. In such case, the lockout 4290 moves towards the drive shaft 4230. It should be noted that the retraction stroke is longer than the firing stroke so that the drive collar 4240 moves proximally to its original unfired position, as illustrated in FIG. In this retracted position of the drive collar 4240, the lockout 4290 is engaged with the drive shaft 4230 and the frame 4222 of the staple cartridge 4220. More specifically, each lockout 4290 enters a lockout opening defined between the drive shaft 4230 and the cartridge frame 4222. Referring now to FIG. 78, each lockout opening is defined by an opening wall 4295 of drive shaft 4230 and an opening wall 4296 of frame 4222. When the lockout pin 4292 enters the lockout opening, the drive collar 4240 can not be rotated by the drive shaft 4230 and the firing system of the staple cartridge 4220 is locked out. As a result, this particular staple cartridge 4220 can not be used again, and in order to use the tool assembly 4200 again, it needs to be replaced with a new staple cartridge.

  In addition to the above, when the firing drive is in its unfired configuration as shown in FIG. 74, the lockout pin 4292 may or may not be partially positioned within the lockout opening. It should be understood that However, as long as the lockout pin 4292 is partially positioned within the lockout opening, in such a case, the pin 4292 is defined in the drive collar 4240 when the firing drive shaft 4230 rotates. The pin openings 4293 can be displaced distally. Also, as the reader moves the drive collar 4240 to its retracted position, the lockout pin 4292 seats sufficiently deep within the lockout opening defined in the drive shaft 4230 so that the firing drive shaft 4230 It should be appreciated that the pin 4292 is prevented from being displaced distally and out of the lockout opening, even though it has rotated again in its first direction.

  Referring again to FIG. 78, when the drive collar 4240 is in its retracted position, the sidewalls 4295 and 4296 of the lockout opening are aligned with one another. However, as drive shaft 4230 rotates, side walls 4295 defined in drive shaft 4230 rotate out of alignment with side walls 4296 defined in cartridge frame 4222. In some cases, the side wall 4295 may rotate as the firing drive 4230 rotates and may re-align with the side wall 4296 for a moment. In any event, referring now to FIG. 77, the sidewall 4295 is not aligned with the sidewall 4296 when the launch system is in its unfired configuration. As a result, when the firing system is in its unfired configuration, the lockout pin 4292 can not enter the lockout opening and the staple cartridge 4220 can not be unintentionally locked out.

  Referring now to FIG. 80, in at least one alternative embodiment, one or more lockout openings 4295 '' may be defined only within the drive shaft 4230 '' of the tool assembly 4200 ''. . In such embodiments, drive collar 4240 can not rotate relative to drive shaft 4230 "once lockout pin 4292 enters lockout opening 4295". In effect, the drive collar 4240 and drive shaft 4230 '' are synchronously locked together but not necessarily locked to the frame of the tool assembly 4200 '', thereby allowing the drive shaft 4230 'to 'Is rotated relative to the drive collar 2440 and is prevented from displacing the drive collar 2440 distally.

  In at least one alternative embodiment, referring now to FIG. 79, each of the firing drive lockouts has a different configuration such that each lockout pin is uniquely indexed to its corresponding lockout opening There is. For example, tool assembly 4200 'may be configured with a first lockout pin configured to enter a first lockout opening defined by side walls 4295 and 4296, and a second defined by side walls 4295' and 4296 '. And a second lockout pin configured to enter the lockout opening. However, the first lockout pin of the tool assembly 4200 'is dimensioned and configured such that it can not enter the second lockout opening, correspondingly the second lockout pin is Sizing and configuration so that it can not enter the lockout opening of the. In addition, either the first lockout pin or the second lockout pin may enter the opening formed by the combination of side walls 4295 and 4296 ', or the opening formed by the combination of side walls 4295' and 4296. I can not do it.

  As mentioned above, a stapling instrument configured to deploy a circular row of staples may include an articulation joint. The articulation joint is configured to allow the end effector of the stapling instrument to articulate relative to the shaft of the stapling instrument. Such stapling instruments can assist the surgeon in placing the end effector in the rectum and / or colon of the patient. In various embodiments, referring to FIG. 81, a stapling instrument configured to deploy a circular row of staples (eg, a stapling instrument 9000 or the like) may be contourable or adjustable. 9010 can be included. Frame 9010 may be configured to be permanently deformed during use. In at least one such embodiment, frame 9010 is comprised of malleable metals such as, for example, silver, platinum, palladium, nickel, gold, and / or copper. In certain embodiments, frame 9010 is made of, for example, malleable plastic. In at least one embodiment, the frame is comprised of a polymer comprising metal ions attached to the polymer chain, such as, for example, ion exchange polymer-metal composites (IPMC). A potential difference, or potential, can be applied to the IPMC material to cause the shaft to defect in a desired manner. In some cases, the shaft can be contoured along one radius of curvature, and in other cases the shaft can be contoured along more than one radius of curvature. For example, while the shaft is in the patient's body, it is possible to change the potential difference or potential to contour the shaft. In certain embodiments, the contourable portion of the frame includes a plurality of pivotable links. In at least one embodiment, the contourable portion of the frame comprises a visco-elastic material.

  In addition to the above, the stapling instrument may further include a lock configured to releasably retain the contourable portion of the frame of the stapling instrument in its contoured configuration. In at least one case, the frame of the stapling instrument includes an articulatable frame link and one or more longitudinal tension cables, which longitudinally tension the frame link The frame link can be locked together by pulling. In some cases, each frame link can include a longitudinal opening extending through the frame link configured to receive a distally moveable rod. The rod is flexible enough to pass through the longitudinal openings, which may not completely align with each other when the contourable portions are contoured, but retains the stapling instrument in its contoured configuration It has sufficient rigidity to

  As described herein, the surgical instrument may be comprised of multiple modules assembled together. For example, in at least one embodiment, a surgical instrument includes a first module that includes a handle and a second module that includes a shaft assembly. While the shaft assembly includes an end effector configured to staple and / or cut tissue of a patient, the shaft assembly can include any suitable end effect. In various examples, the end effector includes a third module attachable to the shaft assembly. Referring now to FIGS. 82 and 83, the handle, such as handle 20, includes a controller and a display 10000 in communication with the controller. The controller is configured to display data on the operation of the surgical instrument on the display 10000. The data displayed on display 10000 conveys to the surgeon information regarding at least one operating parameter of the first module and / or at least one operating parameter of the second module. For example, the controller can display data on the progress of the staple firing stroke on the display unit 10000.

  In addition to the above, the shaft assembly includes a second display. For example, while shaft assembly 2000 includes display 10100, any of the shaft assemblies disclosed herein can include a display, such as, for example, display 10100. The second module includes its own controller configured to display data on the operation of the surgical instrument on display 10100. Similar to the above, the data displayed on display 10100 conveys information regarding at least one operating parameter of the first module and / or at least one operating parameter of the second module. The controller of the second module is in signal communication with the controller of the first module, but in one embodiment, the controller of the second module may operate independently of the controller of the first module. In certain alternative embodiments, the second module does not include a controller. In such an embodiment, the controller of the first module is in signal communication with the first display 10000 and the second display 10100 and is displayed on the first display 10000 and the second display 10100 Control the data.

  As mentioned above, tool assembly 2000 includes an anvil and a staple cartridge. The handle 20 includes an actuation system configured to move the anvil relative to the staple cartridge. The anvil controls the distance, or clearance, between the anvil and the staple cartridge, resulting in a constant relative to the staple cartridge to control the formed height of the staples as they are ejected from the staple cartridge. It can be positioned within the range. For example, the anvil is positioned closer to the staple cartridge to deform the staples to a shorter formed height and farther away to deform the staples to a higher formed height. In any event, the second display 10100 of the tool assembly 2000 is configured to indicate the position of the anvil relative to the staple cartridge and / or to indicate the height at which the staples are formed or formed. . In various embodiments, the shaft assembly can include an actuator configured to control the function of the end effector and a display adjacent to the actuator that displays data regarding the function of the end effector.

  Referring to FIG. 1, tool assembly 1500 includes a shaft and an end effector extending from the shaft. The shaft includes a shaft frame and a longitudinal shaft axis. The end effector includes an end effector frame and a longitudinal end effector axis. The end effector further includes a distal head and a rotational joint that allows the distal head to rotate relative to the end effector about a longitudinal end effector axis. The distal head includes a first jaw and a second jaw. The first jaw includes a staple cartridge including staples removably stored therein, or a channel configured to receive such a staple cartridge, and the second jaw deforms the staples. Including an anvil configured. The second jaw is movable relative to the first jaw between an open position and a closed position. However, other embodiments are envisioned in which the first jaw is movable relative to the second jaw and / or both the first and second jaws are movable relative to one another. Be done.

  In certain embodiments, the tool assembly can include an articulation joint in addition to the rotational joint. In at least one such embodiment, the rotational joint is distal to the articulation joint. In such embodiments, rotation of the distal head does not affect the angle at which the end effector has articulated. However, other embodiments are envisioned where the articulation joint is distal to the revolute joint. Such an embodiment can move the distal head in a wide range of arcs. In either case, the longitudinal end effector axis is movable relative to the longitudinal shaft axis. In at least one case, the longitudinal end effector axis is movable between a position co-linear with the longitudinal shaft axis and a position transverse to the longitudinal shaft axis.

  In addition to the above, the distal head of tool assembly 1500 is rotatable between an initial position and a rotational position. In at least one case, the distal head is rotatable between the zero or top dead center position and the second position. In some cases, the distal head is rotatable over at least a 360 degree range of motion. In other cases, the distal head is rotatable over less than 360 degrees of rotation. In either case, the tool assembly 1500 and / or the handle 20 are configured to track the rotational position of the distal end. In various examples, the tool assembly 1500 and / or the handle 20 directly track the rotation of the distal head in addition to an electric motor operably coupled to the distal head of the end effector and / or And an encoder configured to indirectly track the rotation of the distal head by evaluating the rotational position of the shaft of the electric motor. The controller of the handle 20 is in signal communication with the encoder, and is configured to display, for example, the rotational position of the distal head on the display 10000.

  In at least one embodiment, the orientation and placement of the data displayed on display 10000 is static but the distal head of the end effector rotates. Of course, the data displayed on display 10000 in such an embodiment may be updated by the surgical instrument controller, but the data display may be redirected as the distal head is rotated and / or It will not be relocated. Such embodiments can provide the surgeon with the information necessary to properly use the surgical instrument in the static field. In at least one alternative embodiment, the data fields of display 10000 are dynamic. In this context, the term dynamic has more to say that the data is updated on the display 10000. Rather, the term dynamic means that data is redirected and / or repositioned on the display 10000 as the distal head rotates. In at least one case, the orientation of the data tracks the orientation of the distal head. For example, if the distal head rotates 30 degrees, the data field on the display 10000 will rotate 30 degrees. In various examples, the distal head is rotatable 360 degrees and the data field is rotatable 360 degrees.

  In addition to the above, the data fields can be arranged in any orientation that matches the orientation of the distal head. Such an embodiment can provide the surgeon with an accurate and intuitive sense of the orientation of the distal head. In a particular embodiment, the controller directs the data field in an orientation that most closely matches the orientation of the distal head selected from the array of discrete locations. For example, if the distal head is rotated 27 degrees and the selectable individual data field positions are 15 degrees apart, the controller can redirect the data fields 30 degrees from the data orientation. Similarly, for example, if the distal head is rotated 17 degrees and the selectable individual data field positions are 5 degrees apart, the controller can redirect the data fields 15 degrees from the data orientation . In at least one embodiment, the orientation of the data is aligned with the features of the surgical instrument itself. For example, the orientation of the data in handle 20 is aligned with an axis extending through the grip of handle 20. In such an embodiment, the controller can ignore the orientation of the handle 20 relative to its environment. However, in at least one alternative embodiment, the orientation of the data is, for example, aligned with the gravity axis.

  In addition to the above, the controller is configured to redirect the entire data field displayed on display 10000 relative to the orientation of the distal head. In one embodiment, the controller is configured to redirect only a portion of the data field displayed on display 10000 relative to the orientation of the distal head. In such embodiments, a portion of the data field is held stationary with respect to the data orientation, while another portion of the data field is rotated with respect to the data orientation. In a particular embodiment, the first portion of the data field is rotated by a first rotation angle and the second portion of the data field is rotated by a second rotation angle in the same direction. For example, the second portion may be rotated less than the first portion. In various embodiments, a first portion of the data field is rotated in a first direction and a second portion of the data field is rotated in a second or opposite direction.

  In addition to the above, the data fields may be redirected and / or repositioned in real time, or at least substantially in real time, with rotation of the distal head. Such embodiments provide very responsive data display. In one embodiment, the reorientation and / or repositioning of the data field may be behind the rotation of the distal head. Such embodiments can provide low jitter data presentation. In various embodiments, the first portion of the data field is redirected and / or rearranged at a first rate, and the second portion of the data field is redirected at a second or different rate. It is attached and / or rearranged. For example, the second part may be rotated at a slower speed.

  As mentioned above, the data fields on display 10000 rotate as the distal head of the end effector rotates. However, in another embodiment, the data field, or a portion of the data field, may translate as the distal head rotates. As also mentioned above, the controller of the surgical instrument is configured to redirect and / or reposition the data field on the handle display 10000. However, the controller of the surgical instrument may, for example, redirect and / or reposition data fields on a second display, such as a shaft display.

  Referring again to FIGS. 15 and 83, the tool assembly 2000 includes an actuator 10200 configured to actuate an articulation drive system of the tool assembly 2000. The actuator 10200 is rotatable, for example, about a longitudinal axis that is parallel or at least substantially parallel to the longitudinal axis of the shaft 2100. The actuator 10200 is operatively coupled to, for example, a potentiometer that is in signal communication with the controller of the handle 20. When the actuator 10200 rotates in a first direction about its longitudinal axis, the potentiometer detects the rotation of the actuator 10200 and the controller actuates the electric motor to articulate the end effector 2200 in a first direction. Let Similarly, when the actuator 10200 rotates in a second or opposite direction about its longitudinal axis, the potentiometer detects the rotation of the actuator 10200 and the controller actuates the electric motor to cause the end effector 2200 to Articulate in a second or opposite direction. In various examples, end effector 2200 articulates in a first direction, for example, by about 30 degrees from the longitudinal axis, and / or articulates in a second direction, or in an opposite direction, by about 30 degrees from the longitudinal axis. can do.

  As the reader will appreciate, in addition to the above, the tool assembly 2000 does not have a built-in electric motor configured to operate the articulation drive system. Rather, the electric motor of the articulation drive system is, for example, in a handle, such as the handle 20, to which the tool assembly 2000 is attached. As a result, an actuator on the removable shaft assembly controls the movement of the handle. In one embodiment, the electric motor of the articulation drive system may be within tool assembly 2000. In either case, the display 10100 is configured to at least display the articulation of the end effector 2200 in some manner. As the reader will appreciate, the display 10100 is adjacent to the actuator 10200 so that the surgeon can easily view the input and output of the articulation drive system simultaneously.

  In addition to the above, a surgical tool assembly that includes a contourable shaft can be advantageously formed, for example, into a shape that fits into a patient's rectum or colon. However, such a contourable shaft can not withstand significant tensile and / or compressive loads. To compensate for this, in various embodiments, only the rotatable drive system may extend through the contourable portion of the shaft. In such cases, the shaft needs to resist only the rotational reaction force generated by the rotatable drive system. In such embodiments, rotational movement of the drive system may be converted to linear movement distal to the contourable shaft portion, if necessary. Such longitudinal movement may generate tension and / or compression forces, but such forces are canceled or eliminated within the end effector, ie, distal to the contourable shaft portion It can be offset. Such embodiments may also utilize an articulation joint positioned distal to the contourable shaft portion. In such embodiments, the tool assembly can not utilize a push-pull drive system that traverses the contourable shaft portion.

  An anvil 6020 of a circular stapling instrument is illustrated in FIGS. 84 and 85. Anvil 6020 includes a tissue compression surface 6022 and an annular array of staple forming pockets 6024 defined in tissue compression surface 6022. The anvil 6020 further includes a frame 6028, a mounting mount 6026, and a stem extending from the mounting mount 6026. The stem is configured to be removably attached to the closure drive of the circular stapling instrument such that the anvil 6020 can be moved towards and away from the staple cartridge of the circular stapling instrument There is. The compression surface 6022, the mounting mount 6026, and the frame 6028 may be made of, for example, stainless steel, but any suitable material (s) can be used.

  In addition to the above, anvil 6020 includes a tissue support 6030. Tissue support 6030 is positioned within an annular opening defined in tissue support surface 6022. Tissue support 6030 is tightly fixed within anvil 6020 so that relative movement, if any, between tissue support 6030 and anvil 6020 is minimal. Tissue support portion 6030 includes an annular tissue support surface 6032 adjacent an annular tissue compression surface 6022 of anvil 6020. Tissue support 6030 further includes a bottom wall 6038 positioned adjacent to anvil frame 6028 of anvil 6020, in addition to an annular inner wall 6036 defined therein.

  Referring now to FIG. 86, the circular stapling instrument comprises a staple cartridge 6040 including a first annular staple row 6070, a second annular staple row 6080, and staples staples 6070 and 6080 during the firing stroke of the firing drive. And a firing drive configured to be ejected from the cartridge 6040. As illustrated in FIG. 86, staples 6070 and 6080 are deformed by forming pocket 6024 when ejected from staple cartridge 6040. In various instances, staples 6070 and staples 6080 are deformed to the same height, while in other cases staples 6070 and staples 6080 are deformed to different heights. For example, staple 6070 may be deformed to a shorter deformation height than staple 6080. In another embodiment, the staples 6080 are deformed to a shorter height than the staples 6070.

  Additionally or alternatively, staples 6070 and staples 6080 can have different unformed heights. For example, staple 6070 may have an unformed height shorter than staple 6080. In another embodiment, staples 6080 have a shorter unformed height than staples 6070. In some cases, staples 6070 and staples 6080 have the same unformed height.

  In addition to the above, when the staples 6070 and 6080 are deformed relative to the anvil 6020 to staple the tissue T captured between the anvil 6020 and the staple cartridge 6040, the stapling instrument dissects the tissue T Can. A firing drive that ejects the staples from their staple cavities drives the cutting member 6050 towards the tissue T and anvil 6020. After severing the tissue T, the distal edge of the cutting member 6050 slides along the inner sidewall 6036 of the tissue support 6030 without severing the inner sidewall 6036. The cutting edge of cutting member 6050 is annular and aligns with annular inner wall 6036 of tissue support 6030. The cutting member 6050 is advanced into the anvil 6020 until the cutting member 6050 severs the bottom wall 6038 as illustrated in FIG.

  When driving the staples 6070 and 6080 against the anvil 6020 and / or cutting tissue, the firing drive is subjected to various loads. For example, the firing drive may be subject to increased load when severing tissue that has been pre-stapled, such as with staples 6090 (FIG. 86). However, disconnection of the bottom wall 6038 by the cutting member 6050 causes an abrupt change or impact of the force transmitted through the firing drive. This sudden change in force may be sensed by an electronic sensor system configured to detect load variations of a physician using a surgical stapler and / or the firing drive. The tissue support 6030 can be made of a material that can make a noise when the cutting member 6050 loads the bottom wall 6038. In at least one case, tissue support 6030 comprises, for example, plastic. In any event, a break in the bottom wall 6038 can be detected, and once detected, the physician and / or the electronic sensor system can determine that the cutting process is complete.

  The firing drive may simultaneously deform the staples 6070, 6080 and incise the tissue with the cutting member 6050, but offset the formation of the staples and the cutting of the tissue. In at least one case, the tissue cutting process is not initiated until the staple forming process is complete.

  The surface 6032 can partially support the tissue T, but when the cutting member 6050 moves towards the bottom wall 6038 the cutting member 6050 is between the inner wall 6036 of the tissue support 6030 and the mounting mount 6026 It should be understood from FIG. 86 that tissue T can be pushed into the defined cavity. In other words, the cutting member 6050 can drag the tissue T along the wall 6036 before finally cutting the tissue T. In such cases, the incision made by cutting member 6050 may not be accurate. Discussed below is an improvement over the embodiment disclosed in FIG.

  Referring now to FIGS. 87 and 88, tissue support 6030 of anvil 6020 has been replaced with tissue support 6130. Tissue support 6130 includes a first (or outer) annular wall 6131 and a second (or inner) annular wall 6133. The inner wall 6133 defines an opening 6136 configured to receive the mounting mount 6026 snugly. The outer wall 6131 and the inner wall 6133 are connected by a lateral wall 6132. The lateral wall 6132 radially extends between the inner wall 6133 and the outer wall 6131 around the center of the tissue support 6130. The lateral walls 6132 are spaced apart from one another at equal intervals. However, alternative embodiments are envisioned where the lateral walls 6132 are not equally spaced from one another. In either case, the lateral wall 6132 defines an annular array of cavities 6134 in the tissue support 6130. In various examples, every side of each cavity 6134, for example, other than the side facing the tissue, may be enclosed. In other cases, the side of the cavity facing the tissue may be enclosed.

  Outer wall 6131 and inner wall 6133 of tissue support 6130 are configured to support tissue when tissue is being severed by cutting member 6050. The lateral wall 6132 also supports or prevents tissue from sliding against the outer wall 6131 and the inner wall 6133 when the tissue is transected, in addition to supporting the tissue. It should be understood that although tissue may enter cavity 6134 when tissue is transected, relative motion between tissue and the sidewall may be significantly reduced. The configuration and arrangement of the lateral wall 6132 can be selected to provide greater support to the tissue or less support to the tissue, depending on the amount of support desired. For example, thicker lateral wall 6132 can provide greater tissue support than thinner lateral wall 6132. Similarly, more lateral walls 6132 can provide greater tissue support than thinner lateral walls 6132.

  As the cutting member 6050 is moving during its cutting stroke, the cutting member 6050 cuts tissue and severs the lateral wall 6132. The cutting member 6050 is annular and severs the lateral wall 6132 adjacent the outer wall 6131. However, the cutting member can sever the wall 6132 at any suitable position. In any event, the lateral wall 6132 supports the tissue before, during, and after cutting the tissue to prevent or possibly drag the tissue along the outer wall 6131 and / or the inner wall 6133 At least reduce. Similar to tissue support 6030, tissue support 6130 includes a bottom wall 6138 that is severed at the end of the cutting stroke.

  A surgical stapler including staple cartridge 6240 and anvil 6220 is disclosed in FIGS. Staple cartridge 6240 is similar to staple cartridge 6040 in many respects. Anvil 6220 is similar to anvil 6020 and anvil 6120 in many respects. The anvil 6220 includes a mounting stem 6226 and an annular tissue support 6230 positioned around the mounting stem 6226. Tissue support 6230 includes a central opening configured to receive stem 6226 snugly. Tissue support 6230 further includes a lateral wall 6232 radially extending from outer wall 6231, in addition to annular outer wall 6231 positioned adjacent to the tissue compression surface of anvil 6220. Tissue support 6230 does not include an annular inner wall, and the inner end of lateral wall 6232 can be freely deflected. Tissue support 6230 further includes a bottom wall 6238, which is dissected by cutting member 6050, as described above.

  A surgical stapler including staple cartridge 6240 and anvil 6220 is illustrated in FIGS. 91 and 92. However, the reader should understand that tissue support 6230 of anvil 6220 has been replaced with tissue support 6330. Tissue support 6330 includes an annular central opening configured to receive stem 6226 snugly. Tissue support 6330 further includes a top wall 6332, a bottom wall 6338, and a side wall 6336 extending between top wall 6332 and bottom wall 6338. Embodiments are envisioned where top wall 6332 and bottom wall 6338 are parallel or at least substantially parallel, but walls 6332 and 6338 are not parallel. Embodiments are envisioned where side walls 6336 are parallel or at least substantially parallel, but side walls 6336 are not parallel.

  The walls 6332, 6336 and 6338 define an annular cavity 6334 therebetween. The cavity 6334 is square or at least substantially square. The cavity 6334 extends uninterrupted around the stem 6226, but other embodiments are envisioned, for example, where the cavity 6334 is interrupted by sidewalls and / or the shape of the cavity 6334 changes.

  Similar to the above, the tissue support 6330 is configured to support tissue when the tissue is being severed by the cutting member 6050. The tissue support 6330 is snugly received within the anvil 6220 such that the tissue support 6330 does not move or at least substantially does not move relative to the anvil 6220. Furthermore, the tissue support 6330 has a rigid box-shaped cross section so that deflection of the tissue support 6330 is minimized or minimal while the cutting member 6050 severs tissue. including. As illustrated in FIG. 91, a gap exists between the bottom wall 6338 and the inner side wall 6336. Such a gap may provide tissue support 6330 with some flexibility. However, other embodiments are envisioned where such gaps do not exist. The tissue support 6330 may be, for example, plastic, but in various embodiments, the tissue support 6330 may be, for example, flexible and / or elastomeric material.

  The cutting member 6050 severs the tissue support 6330 during its cutting stroke. As illustrated in FIG. 92, the cutting member 6050 severs the top wall 6332 after severing tissue and then enters the cavity 6334. Top wall 6332 includes an annular notch 6333 defined in the upper wall, which is in alignment with the annular cutting edge of cutting member 6050. The notch 6333 reduces the cross section of the upper wall 6332 and facilitates dissection of the upper wall 6332. The cutting member 6050 can also sever the bottom wall 6338 during its cutting stroke. As the reader will appreciate, the severing of the top 6332 and bottom 6338 walls of the tissue support 6330 can create a force impact within the firing drive of the stapling instrument. The upper wall 6332 so that the doctor of the surgical instrument and / or the electronic sensor system can recognize the impact difference and misinterpret the incision in the upper wall 6332 as the end of the firing / cutting stroke. And bottom wall 6338 may be structurally configured to provide different impacts.

  Referring again to FIGS. 91 and 92, the top wall 6332 of the tissue support 6330 is aligned or at least substantially aligned with the tissue compression surface 6022 of the anvil 6220. Additionally or alternatively, the top wall 6332 may be posterior to the tissue compression surface 6022 and / or may extend above the tissue compression surface 6022. The upper wall 6332 of the tissue support extends above the forming surface 6024 of the anvil 6220. In addition to or in place of the above, the top wall 6332 may be behind and / or aligned with the forming surface 6024.

  A surgical stapler including staple cartridge 6240 and anvil 6220 is shown in FIGS. 93 and 94. However, the reader should understand that tissue support 6230 of anvil 6220 has been replaced with tissue support 6430. Tissue support 6430 includes an annular central opening configured to receive stem 6226 snugly. Tissue support 6430 further includes a top wall 6432, a bottom wall 6438, and a side wall 6436 extending between top wall 6432 and bottom wall 6438. The walls 6432, 6436, and 6438 define an annular cavity 6434 therebetween. The cavity 6434 is square or at least substantially square. The cavity 6434 extends uninterrupted around the stem 6226, but other embodiments are envisioned, for example, where the cavity 6434 is interrupted by sidewalls and / or the shape of the cavity 6434 changes.

  Similar to the above, tissue support 6430 is configured to support tissue as it is being severed by cutting member 6050. Tissue support 6430 is snugly received within anvil 6220 such that tissue support 6430 does not move or at least substantially does not move relative to anvil 6220. In addition, the tissue support 6430 has a rigid polygonal cross section so that deflection of the tissue support 6430 is minimized or minimal while deflection of the cutting member 6050 cuts through tissue. including. There is a gap between the bottom wall 6438 and the inner sidewall 6436 as illustrated in FIG. Such a gap may provide tissue support 6430 with some flexibility. However, other embodiments are envisioned where such gaps do not exist. Although tissue support 6430 is made of, for example, plastic, in various embodiments, tissue support 6430 may be made of, for example, a flexible material and / or an elastomeric material.

  As illustrated in FIGS. 93 and 94, the inner sidewall 6436 is shorter than the outer sidewall 3436. However, other embodiments are envisioned where the outer sidewall 6436 is shorter than the inner sidewall 6436. Further, the top wall 6432 is not parallel to the bottom wall 6438. More specifically, top wall 6432 includes ramps and / or other portions of wall 6432 that extend transversely to bottom wall 6438.

  The cutting member 6050 severs the tissue support 6430 during its cutting stroke. As illustrated in FIG. 94, the cutting member 6050 severs the top wall 6432 after severing the tissue and then enters the cavity 6434. The cutting member 6050 can also sever the bottom wall 6438 during its cutting stroke.

As mentioned above, the tissue support disclosed herein is configured to support tissue as it is being cut by the cutting member. Often, the tissue being cut by the cutting member is pre-stapled, ie stapled, for example, during the early stages of the surgical procedure. In various instances, such staples may also be cut by the cutting member, although such staples are made of metal such as, for example, titanium and / or stainless steel. In other cases, such staples may not be dissected by the cutting member, but rather may be pushed into the material comprising the tissue support. Regardless of whether the staples are incised by the cutting member, the tissue support disclosed herein may, in various examples, localize the staples captured by the cutting member to the tissue support within the tissue support. It has sufficient strength and / or rigidity so as not to cause deformation more than the plastic deformation. In at least one such example, the local plastic deformation is limited to less than a predetermined characteristic length (CL) of the staple in any direction relative to the staple. In at least one case, the material of the tissue support is selected such that the staples captured in the tissue support can only form a plastic deformation region in the tissue support, for example having a diameter of less than 2 ^* CL It may be done. In other cases, the material of the tissue support may be such that the staples captured in the tissue support may only form a plastic deformation region in the tissue support, for example having a diameter of less than 1.5 ^* CL It may be selected. The representative length of the staple can be, for example, the width of the staple crown, the backspan, and / or the formed height of the staple leg in a modified configuration of the staple. In addition, the tissue support disclosed herein may be constructed of a material having a hardness sufficient to support the staples as the staples are being cut by the cutting member. In at least one case, the hardness of the material comprising the tissue support is greater than or equal to the hardness of the material comprising the staple being incised in contact with the tissue support. In some cases, the hardness of the material making up the tissue support is less than the hardness of the material making up the staple being cut, but the structural design of the tissue support makes the area of plastic deformation acceptable to the tissue support It is sufficient to prevent overstretching plastically. In some cases, the energy required to dissect the tissue and the formed staples in the tissue is less than the energy needed to dissect the tissue support. In various examples, the material comprising the tissue support can be resistant to being swept by staples. In at least one case, a biocompatible lubricant may be disposed on the tissue support and / or impregnated into the tissue support to prevent the staples from catching on the tissue support.

  In various examples, the tissue compression surface of the anvil and the tissue contacting surface of the tissue support are flat or at least substantially flat. Such a configuration can distribute the force applied by the anvil over a wide area of tissue. Other embodiments are envisioned where the tissue compression surface of the anvil and / or the tissue contact surface of the tissue support is not flat. In some cases, the tissue compression surface of the anvil and / or the tissue contacting surface of the tissue support may be configured to engage tissue and grip tissue, a tissue gripping member extending from these surfaces, or a spike Including the department. Such tissue gripping members can, for example, reduce relative movement (or slip) between the tissue and the anvil. In at least one case, the density of the tissue gripping members on the tissue compressing surface of the anvil and the density of the tissue gripping members on the tissue contacting surface of the tissue support are the same. In other cases, the density of the tissue gripping members on the tissue contacting surface of the tissue support is higher than the density of the tissue gripping members on the compression surface of the anvil. When the tissue support is positioned radially inward with respect to the compression surface of the anvil, the tissue grasping member can in such case prevent tissue from flowing radially inward or sliding.

  Anvil 6520 is shown in FIG. Anvil 6520 includes, in addition to tissue compression surface 6522, a forming pocket defined within tissue compression surface 6522. The forming pockets are configured to deform the staples into the desired configuration when the staples are ejected from their staple cartridges. Each forming pocket includes a pair of cups, each of the pair of cups configured to deform the legs of the staples. For example, a pair of forming cups is formed with a first forming cup 6530a configured to deform the first leg of the staple and a second forming configured to deform the second leg of the staple And a cup 6530b. The first forming cup 6530a and the second forming cup 6530b are mirror images of each other with respect to an axis 6531 extending between the first forming cup 6530a and the second forming cup 6530b, but in other configurations It can be used.

  The first forming cup 6530a includes a first (or outer) end 6532 and a second (or inner) end 6534. First forming cup 6530 a further includes a bottom (or bathtub surface) 6536 extending between outer end 6532 and inner end 6534. The first end 6532 is configured to receive the leg of the staple and to initiate the leg formation process. The first end 6532 includes a curved surface configured to deflect the staple leg toward the second end 6534. The bottom surface 6536 includes a curved surface (or concave surface) configured to redirect the staple legs at least partially towards the staple cartridge. The second end 6534 includes a curved surface configured to guide the staple leg out of the forming cup 6530a.

  The second forming cup 6530b includes a structure similar to that of the first forming cup 6530a and is configured to deform the second leg of the staple. As a result of the above, the first forming cup 6530a guides the first leg of the staple towards the second leg, and the second forming cup 6530b makes the second leg of the staple the first. Guide towards the legs. In various examples, the first forming cup 6530a and the second forming cup 6530b cooperate to, for example, deform the staples into a B-shaped configuration. However, the forming cup may be configured to deform the staples into any suitable configuration.

  Referring primarily to FIG. 96, each forming cup 6530 (6530a and 6530b) includes one lateral sidewall 6537 and a second extending between the first end 6532 and the second end 6534. And lateral side walls 6539. In various examples, the first lateral sidewall 6537 and the second lateral sidewall 6539 are mirror images of one another with respect to a longitudinal axis 6533 extending through the center of the forming cup 6530. In other cases, the first lateral sidewall 6537 and the second lateral sidewall 6539 are not mirror images of one another. In either case, the side walls 6537, 6539 are, for example, sloped or inclined to guide the staple legs towards the center of the forming cup, ie towards the axis 6533.

  Each forming cup 6530 includes a groove or channel 6538 defined in its bottom surface 6536. The groove 6538 extends longitudinally between the first end 6532 and the second end 6534 of the forming cup 6530. The grooves 6538 extend parallel to the central longitudinal axis 6535 of the forming cup 6530 or laterally offset with respect to the central longitudinal axis 6535. The groove 6538 is wider than the legs of the staple deformed by the forming cup 6530, although other embodiments are envisioned where the groove 6538 is narrower than the legs of the staple. In either case, the groove 6538 is configured to guide the staple legs along a predetermined path within the forming cup 6530.

  In various examples, the grooves of forming cup 6530 are configured to twist the legs while deforming the legs of the staples. In at least one case, the staples are planar or at least substantially planar before being deformed. In at least one such example, when the staple is ejected from the staple cartridge, the legs and base of the staple lie in the same plane as the longitudinal axis 6535. The first end 6532 and the bottom 6536 are angled and / or otherwise configured to direct the legs towards the groove 6538 as the staple legs enter the forming cup 6530. After the staple legs enter the groove 6538, the groove 6538 twists the staple legs together with the base of the staple such that the staple legs come out of the plane. As a result of the above, the configuration of the unformed staple is planar, but the configuration of the formed staple is non-planar. However, other embodiments are envisioned where the staples have a non-planar configuration before and after the staples are deformed.

  The grooves 6538 of the forming cup 6530 are positioned on the same side of the longitudinal axis 6535 in terms of a given set of forming cups 6530 and configured to twist both of the staple legs onto the same side of the staple base It is done. However, other embodiments are envisioned where the first staple leg is twisted on one side of the staple base and the second staple leg is twisted on the other side of the staple base. In at least one such embodiment, the first groove 6538 is disposed on the first side of the longitudinal axis 6535 and configured to twist the first staple leg to the first side of the staple base The second groove 6538 is disposed on the second side of the longitudinal axis 6535 and is configured to twist the second staple leg to the second side of the staple base.

  The grooves 6538 of the forming cup 6530 are collinear or at least substantially collinear in the context of a given set of forming cups 6530. However, other embodiments are envisioned where each groove 6538 is disposed on the same side of the longitudinal axis 6535, but not co-linear with one another. In at least one such example, the grooves 6538 are parallel to one another, but in other such examples, the grooves 6538 are not parallel to one another.

  Referring mainly to FIG. 96, the groove 6538 is deeper than the bottom surface 6536 of the forming cup 6530. However, other embodiments are envisaged in which the grooves of the forming cup and the bottom surface have the same depth.

  In various examples, where the anvil 6520 is part of a longitudinal end effector configured to apply a longitudinal row of staples, the forming cups 6530 are arranged in the longitudinal row. In at least one such example, the grooves 6538 of the forming cup are arranged such that all the staples deployed by the end effector are bent in the same direction out of the plane. In other cases, the groove 6538 bends the staple legs in a first direction, and the first longitudinal row of forming cups 6530 and bends the staple legs in a second (or different) direction. And a second longitudinal row of In some cases, groove 6538 bends the legs of the first staple in the row of staples in a first direction and the legs of the second staple in the row of staples in a second or opposite direction Will be placed.

  In various examples, where the anvil 6520 is part of an annular end effector configured to apply an annular array of staples, the forming cups 6530 are disposed in the annular array. In at least one such example, the groove 6538 is positioned radially outward with respect to the central longitudinal axis 6535 of the forming cup 6530. In other cases, the groove 6538 is positioned radially inward with respect to the central longitudinal axis 6535 of the forming cup 6530. In some cases, the grooves 6538 are positioned radially outward in the first annular row of forming cups 6530 and radially inward in the second annular row of forming cups 6530.

  In addition to the above, the forming pocket of the anvil can include any suitable configuration. In at least one case, the forming pocket may comprise two forming cups that are mirror images of one another with respect to the central axis. Each forming cup includes a triangular configuration having an outer end and an inner end. The inner ends of the pair of forming cups are adjacent to one another. The outer end of the forming cup is wider than the inner end and is configured to receive the legs of the staple. Each forming cup is defined in the bottom surface configured to guide staple legs in the forming cup, in addition to the bottom surface (or bathtub surface) extending between the outer end and the inner end. It further comprises a longitudinal groove. In at least one case, the longitudinal groove is at the center of the bottom of the forming cup.

  An end effector 7000 of a circular stapling assembly is disclosed in FIGS. End effector 7000 includes a staple cartridge that includes a deck 7030 and a cartridge body 7040. The deck 7030 includes a tissue compression surface 7031 and a staple cavity 7032 defined within the tissue compression surface 7031. The staple cavities 7032 are arranged in a first (or inner) annular row and a second (or outer) annular row. Each staple cavity 7032 in the inner row includes a first staple 7070a removably stored therein, and each staple cavity 7032 in the outer row includes a second staple 7070b removably stored therein. Including.

  End effector 7000 further includes a staple driver configured to push the staples from the staple cartridge. For example, the staple cartridge may be configured to eject a first annular staple driver array 7060a configured to eject a first staple array 7070a from a cartridge body 7040 and a second configured to eject a second staple array 7070b. And an annular tabular driver row 7060b of Staple drivers 7060 a and 7060 b are positioned within and / or aligned with staple cavities 7032 defined in deck 7030. Staple drivers 7060 a and 7060 b are slidable within staple cavity 7032 to eject staples 7070 a and 7070 b from staple cavity 7032, respectively.

  End effector 7000 further includes an anvil 7020. The anvil 7020 includes a tissue compression surface 7021 and a staple forming pocket 7022 defined within the compression surface 7021. The staple forming pockets 7022 are arranged in a first (or inner) annular row and a second (or outer) annular row. The staple forming pocket 7022 aligns with the staple cavity 7032 such that the staples 7070 a, 7070 b contact the staple forming pocket 7022 as the staples 7070 a, 7070 b are ejected from the staple cavity 7032.

  End effector 7000 further includes a firing member 7056 configured to lift staple drivers 7060a and 7060b within staple cavity 7032 to eject staples 7070a and 7070b from staple cavity 7032 respectively. The firing member 7056 includes a base 7054 and an inclined surface 7055. The base 7054 is slidably positioned within a recess 7052 defined in the firing drive 7050. Inclined surface 7055 is slidably positioned within slot 7041 defined in cartridge body 7040. As described in more detail below, the angled surface 7055 is configured to slide within the slot 7041 and progressively contact the staple drivers 7060a, 7060b to eject the staples 7070a, 7070b from the staple cavity 7032.

  In addition to the above, the firing member 7056 is movable throughout the firing stroke to cause the staples 7070 a, 7070 b to be ejected from the staple cavity 7032. During the firing stroke, the firing member 7056 moves along the curved (or arcuate) path defined by the slot 7041. Referring mainly to FIG. 97, the slot 7041 includes a first end 7042, a second end 7049, and a continuous path therebetween. Inclined surface 7055 of firing member 7056 is positioned within first end 7042 at the beginning of the firing stroke and within second end 7049 at the end of the firing stroke. The first end 7042 of the slot 7041 is aligned with the inner row of staple cavities 7032 and the second end 7049 of the slot 7041 is aligned with the outer row of staple cavities 7032. The slot 7041 further includes a first circumferential portion 7043 extending around a central longitudinal axis 7090 extending through the end effector 7000. The first circumferential portion 7043 of the slot 7041 aligns with and extends down the staple driver 7060 a in the inner row of staple cavities 7032. As the firing member 7056 moves through the first circumferential portion 7043 of the slot 7041, the ramped surface 7055 of the firing member continuously engages the staple driver 7060a causing the staple 7070a to fire continuously.

  The first circumferential portion 7043 is defined around the longitudinal axis 7090 by a constant or at least substantially constant radius of curvature. However, other embodiments are envisioned where the radius of curvature of the first circumferential portion 7043 is not constant. In at least one such example, the first circumferential portion 7043 comprises a helical structure. In other words, in such a case, the first circumferential portion 7043 moves away from the longitudinal axis 7090 as it extends around the longitudinal axis 7090.

  The second circumferential portion 7045 of the slot 7041 aligns with and extends down the staple driver 7060 b in the outer row of staple cavities 7032. As the firing member 7056 moves through the second circumferential portion 7045 of the slot 7041, the beveled surface 7055 of the firing member continuously engages the staple driver 7060b causing the staples 7070b to fire continuously. The second circumferential portion 7045 is defined around the longitudinal axis 7090 by a constant or at least substantially constant radius of curvature. However, other embodiments are envisioned where the radius of curvature of the second circumferential portion 7045 is not constant. In at least one such example, the second circumferential portion 7045 includes a helical structure. In other words, in such a case, the second circumferential portion 7045 moves away from the longitudinal axis 7090 as it extends around the longitudinal axis 7090.

  In addition to the above, the slot 7041 includes an intermediate transition 7044 between the first circumferential portion 7043 and the second circumferential portion 7045. During the firing stroke, the inclined surface 7055 slides continuously through the first circumferential portion 7043, the transition portion 7044 and then the second circumferential portion 7045. The transition portion 7044 allows the firing member 7056 to reposition between a first staple row of a first radius of curvature and a second staple row of a second radius of curvature. In certain embodiments, the transition 7044 between the first circumferential portion 7043 and the second circumferential portion 7045 may be unnecessary. In at least one such example, the first circumferential portion 7043 can include a first helical configuration, and the second circumferential portion 7045 can, for example, have an endpoint of the first helical configuration be a second helical configuration. A second helical configuration can be included that aligns with the origin of

  The firing member 7056 is driven along its firing path by the firing drive 7050. The firing drive 7050 is driven about the longitudinal axis 7090 by, for example, a manual crank and / or an electric motor. The firing drive 7050 includes a drive recess 7052 defined therein. The base 7054 of the firing member 7056 is positioned within the drive recess 7052. The drive recess 7052 is larger than the base 7054 of the firing member 7056 so that the base 7054 can move or float within the drive recess 7052. The drive recess 7052 is defined by a sidewall that limits movement of the base 7054 within the recess 7052. As the firing drive 7050 rotates about the longitudinal axis 7090, the sidewalls of the drive recess 7052 contact the base 7054 and push the drive member 7056 past the slot 7051. As mentioned above, the slot 7051 has one or more points of change in its radius of curvature, and as the firing member 7056 moves through such points of change, the base 7054 of the firing member 7056 It can slide inside.

  As described above, after the staples in the first (or inner) staple row are sequentially deployed, the staples in the second (or outer) staple row are sequentially deployed. Such embodiments can, for example, control the inner circumference of the colon before stapling outward. In one embodiment, after the staples in the outer staple row are sequentially deployed, the staples in the inner staple row are sequentially deployed. Such embodiments can, for example, establish a boundary in colon tissue prior to stapling inward.

  In various examples, further to the above, the first staple 7070a and the second staple 7070b have the same unformed height. In at least one such example, the first staple 7070a and the second staple 7070b are formed at the same formation height. In other such examples, the first staple 7070a may be formed at a first formed height and the second staple 7070b may be formed at a second formed height different from the first formed height. In at least one such example, the first formed height of the inner staple row is less than the second formed height of the outer staple row. Such an arrangement may, for example, make the transition between stapled and unstapled tissue more gradual. In other cases, the first formed height of the inner staple row is greater than the second formed height of the outer staple row. Such a configuration can, for example, make the innermost tissue of the stapled intestine, for example, more flexible.

  In some cases, additionally to the above, the first staple 7070a has a first unformed height, and the second staple 7070b has a second unformed height different from the first unformed height. . In at least one such example, the first staple 7070a and the second staple 7070b are formed at the same formation height. In other such examples, the first staple 7070a is formed at a first formation height and the second staple 7070b is formed at a second formation height different from the first formation height.

  Although end effector 7000 has two annular staple rows, end effector may have any suitable number of annular staple rows. For example, the end effector may have three annular staple rows. In at least one such example, the staples in the first annular row may have a first unformed staple height and the staples in the second annular row have a second unformed staple height The third staples in the third annular row may have a third green staple height. Further, in at least one such example, the staples in the first annular row may have a first deformed staple height, and the staples in the second annular row have a second deformed staple height. And the third staple in the third annular row may have a third deformed staple height.

  The firing drive 7150 is shown in FIGS. 100-105. Launch drive 7150 includes a rotatable drive shaft 7152 that is rotatable about a longitudinal axis. Launch drive 7150 further includes a three-step sequential driver assembly that includes a first (or inner) driver 7154a, a second (or intermediate) driver 7154b, and a third (or outer) driver 7154c. Drive shaft 7152 includes a drive pin 7151 extending therefrom. Drive pins 7151 extend through the respective drive slots of drivers 7154a, 7154b, and 7154c. For example, the first driver 7154a includes a first drive slot 7153a defined therein, and the second driver 7154b includes a second drive slot 7153b defined therein, and a third driver 7154c includes a third drive slot 7153c defined therein. Drive slots 7153a, 7153b, and 7153c do not have the same configuration. However, drive slots 7153a, 7153b, and 7153c have overlapping configurations that align or at least substantially align at drive pins 7151. For example, in FIG. 100, drive pin 7151 is in an unfired position, and drive slots 7153a, 7153b, and 7153c are aligned with drive pin 7151.

  In addition to the above, FIG. 100 illustrates the drivers 7154a, 7154b, and 7154c in an unfired position. Referring now to FIG. 101, as the drive shaft 7152 rotates during the first portion of its firing stroke, the drive pin 7151 rotates through the circumferential path, causing the drive pin 7151 to engage the sidewall of the drive slot 7153a. In addition, the first driver 7154a is pushed distally or cammed. Notably, during the first portion of the firing stroke, drive pin 7151 has not driven drivers 7154 b and 7154 c distally. As can be seen in FIG. 100, drive slots 7153b and 7153c are aligned with the circumferential path of drive pin 7151 throughout the first portion of the firing stroke. The first driver 7154a is configured to fire the first row of annular staples when the first driver 7154a is displaced distally.

  Referring now to FIG. 102, as drive shaft 7152 rotates during the second portion of its firing stroke, drive pin 7151 rotates through the circumferential path, causing drive pin 7151 to engage the sidewall of drive slot 7153b. In addition, the second driver 7154 b is pushed distally or cammed. Notably, during the second portion of the firing stroke, drive pin 7151 has not driven driver 7154c distally. As above, drive slots 7153a and 7153c are aligned with the circumferential path of drive pin 7151 throughout the second portion of the firing stroke. The second driver 7154b is configured to fire a second row of annular staples when the second driver 7154b is displaced distally.

  Referring now to FIG. 103, as the drive shaft 7152 rotates during the third portion of its firing stroke, the drive pin 7151 rotates through the circumferential path and the drive pin 7151 engages the sidewall of the drive slot 7153c. In addition, the third driver 7154c is pushed distally or cammed. As above, drive slots 7153a and 7153b are aligned with the circumferential path of drive pin 7151 throughout the third portion of the firing stroke. The third driver 7154c is configured to deploy the cutting member when the third driver 7154c is displaced distally. However, in certain embodiments, the third driver 7154c can, for example, deploy a third row of staples.

  As a result of the above, there is no overlap between the first staple firing phase, the second staple firing phase, and the tissue cutting phase. Each step is performed at continuous timing. Thus, the force required to deform the staples and cut the tissue is distributed over the firing stroke. Furthermore, the firing drive 7150 can not cut tissue until the tissue is stapled. Various alternative embodiments are envisioned in which there is some overlap between the first staple firing phase, the second staple firing phase, and / or the tissue cutting phase. In at least one such embodiment, the configuration of drive slots 7153a, 7153b, and 7153c is a partial overlap of the motion of first driver 7154a and second driver 7154b and / or second driver 7154b and third. It may be adapted that there is a partial overlap of the movement of the driver 7154c of.

  Referring primarily to FIGS. 103 and 104, the drivers 7154a, 7154b, and 7154c include cooperating features that prevent or at least prevent the drivers 7154a, 7154b, and 7154c from rotating relative to one another. There is. For example, the first driver 7154a includes a longitudinal key portion 7155a disposed in a longitudinal slot 7156b defined in the second driver 7154b. The key 7155a and the slot 7156b allow the first driver 7154a to slide longitudinally relative to the second driver 7154b, but between the first driver 7154a and the second driver 7154b. It is configured to block rotational movement. Similarly, the second driver 7154b includes a longitudinal key 7155b disposed in a longitudinal slot 7156c defined in the third driver 7154c. The key portion 7155b and the slot 7156c allow the second driver 7154b to slide longitudinally relative to the third driver 7154c, but between the second driver 7154b and the third driver 7154c. It is configured to block rotational movement.

  To retract the drivers 7154a, 7154b, and 7154c, the drive shaft 7152 is rotated in the opposite direction. In such a case, the drive shaft 7152 continuously engages the side wall of the drive slot 7153c, the side wall of the drive slot 7153b, and then the side wall of the drive slot 7153a to form the third driver 7154c, the second The driver 7154 b and the first driver 7154 a are returned to their unfired position (FIG. 100).

  The firing drive 7250 is shown in FIG. Launch drive 7250 operates similarly to launch drive 7150. Launch drive 7250 includes a drive shaft 7252 that is rotatable about a longitudinal axis. Drive shaft 7252 includes a cam surface (or ramp) 7256 that rotates through several stages of the firing stroke. The firing drive 7250 further includes a first driver 7254a, a second driver 7254b, and a third driver 7254c with which the cam 7256 of the drive shaft 7252 engages when the firing drive 7250 rotates. In the first phase of the firing stroke, the cam 7256 engages the cam surface 7255a defined on the first driver 7254a and drives the first driver 7254a distally. In the second phase of the firing stroke, the cam 7256 engages the cam surface 7255b defined on the second driver 7254b and drives the second driver 7254b distally. In the third phase of the firing stroke, the cam 7256 engages the cam surface 7255c defined on the third driver 7254c and drives the third driver 7254c distally.

  The first cam surface 7255a is shorter than the second cam surface 7255b, so that the first driver 7254a has a shorter firing stroke than the second driver 7254b. Similarly, the second cam surface 7255b is shorter than the third cam surface 7255c, so that the second driver 7254b has a shorter firing stroke than the third driver 7254c. Such an arrangement may be useful, for example, to form different rows of staples at different forming heights. In one embodiment, drivers 7254a, 7254b, and 7254c can have any suitable firing stroke. In at least one embodiment, the drivers 7254a, 7254b, and 7254c, for example, have the same firing stroke. Such an arrangement may be useful, for example, to form different rows of staples at the same forming height.

  FIG. 107 is a perspective view of a portion of a staple cartridge 4410 for use with a circular surgical stapling instrument according to at least one embodiment. Various circular surgical stapling instruments are known. For example, US Patent Application No. 14 / 836,110, filed August 26, 2015, entitled "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS", filed on August 26, 2015, is incorporated by reference in its entirety. Discloses the construction of a circular surgical stapling instrument. U.S. Patent Application No. 14 / 498,070, filed September 26, 2014, entitled "CIRCULAR FASTENER CARTRIDGES FOR APPLYING RADIALLY EXPANDING FASTENER LINES", filed on September 26, 2014, the disclosure of which is incorporated herein by reference in its entirety Disclosed is the configuration of a circular surgical stapler. As discussed in these references, the circular surgical stapler generally includes a frame assembly including an attachment configured to operably couple the anvil to the circular surgical stapler.

  Broadly, the anvil includes an anvil head that supports the annular line (s) of the staple forming pocket. The anvil stem or trocar portion is attached to the anvil head and is configured to be releasably coupled to the anvil attachment of the circular stapling instrument. Various circular surgical stapling instruments direct the anvil toward the surgical staple cartridge and away from the staple cartridge so that the target tissue can be clamped between the anvil and the deck of the surgical staple cartridge Includes means for selectively moving. A surgical staple cartridge removably stores a plurality of surgical staples therein, the surgical staples being arranged in one or more annular arrays corresponding to the arrangement of staple forming pockets provided in the anvil Ru. The staples are removably stored in corresponding staple cavities formed in the staple cartridge and supported on corresponding portions of the selectively movable pusher assembly operatively received in the circular stapler. The circular stapler further includes an annular knife or cutting member configured to cut tissue clamped between the anvil and the staple cartridge.

Referring again to FIG. 107, staple cartridge 4410 includes a cartridge body 4411 that defines an annular cartridge deck surface 4412. Cartridge body 4411 includes an inner annular row 4420 of spaced apart inner staple cavities 4422 and an outer annular row 4440 of spaced apart outer staple cavities 4442. As can be seen in FIG. 107, the inner staple cavity 4422 is offset relative to the spaced apart outer staple cavity 4442. An inner surgical staple 4430 is supported within each inner staple cavity 4422 and an outer surgical staple 4450 is supported within each outer staple cavity 4442. The outer staples 4450 in the outer annular row 4440 may have different features than the inner staples 4430 in the inner annular row 4420. For example, as shown in the embodiment of FIG. 108, the outer staple 4450 has an unformed "gull wing" configuration. Specifically, each outer staple 4450 includes a pair of legs 4454, 4464 extending from a staple crown 4452. Each leg 4454, 4464 includes a vertical portion 4456, 4466 respectively extending from crown 4452. The vertical portions 4456, 4466 may be parallel to one another in one embodiment. However, in the illustrated configuration, the vertical portions 4456, 4466 are not parallel to one another. For example, in the illustrated arrangement, the angle _{A 1} between the crown 4452 and the vertical portion 4456,4466 is greater than 90 degrees. See FIG. No. 14 / 319,008, filed Jun. 30, 2014, entitled "FASTENER CARTRIDGE COMPRISING NON-," filed on Jun. 30, 2014, the disclosure of which is incorporated herein by reference in its entirety. UNIFORM FASTENERS ", U.S. Patent Application Publication No. 2015/0297232. However, vertical portions 4456, 4466 may be disposed at other angles with respect to crown 4452. One advantage of having the vertical leg portions 4456, 4466 arranged at an angle greater than 90 degrees with respect to the crown 4452 is that such a configuration temporarily holds the staples in their corresponding staple cavities It can be helpful.

At least one leg 4454, 4464 has an inwardly extending end. In the embodiment shown in FIG. 108, for example, each leg 4454, 4464 includes an inwardly extending leg portion. In the illustrated configuration, leg portion 4458 extends inwardly from vertical leg portion 4456 and leg portion 4468 extends inwardly from vertical leg portion 4466. As can be seen in FIG. 108, the leg portion 4458 is shorter than the leg portion 4468. In other words, the distance _HA between the staple crown 4452 and the point at which the leg portion 4458 bends inwardly from the vertical leg portion 4456 is such that the staple crown 4452 and the leg portion 4468 face inwardly from the vertical leg portion 4466 It is longer than the distance H _C between the point to turn on. Thus, in at least one embodiment, the distance H _B is shorter than the length H _D. Angle _{A 2} of the leg portion 4458 is bent with respect to the vertical leg portion 4556 is equal to the angle _{A 3} of the leg portion 4468 is bent with respect to the vertical leg portion 4466, or, and _{A 2} and _{A 3} may be different from each other . No. 14 / 319,008, filed on Jun. 30, 2014, entitled "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS", filed on Jun. 30, 2014, which is incorporated herein by reference in its entirety. U.S. Patent Application Publication No. 2015/0297232.

In at least one embodiment, each inner surgical staple 4430 can have the configuration illustrated in FIG. As can be seen in FIG. 108, the inner surgical staple 4430 has a crown 4432 and two vertical legs 4434, 4436 extending from the crown 4432. Vertical leg 4434,4436 may extend relatively perpendicularly from the crown portion 4432, or may extend at an angle _{A 4} which may be greater than 90 degrees. Such an arrangement may serve to temporarily hold the staples 4430 in their corresponding staple cavities 4422. However, vertical legs 4434, 4436 may extend from crown 4432 at various angles. In some embodiments, the angles A ₄ are equal to one another. In other embodiments, the angle A ₄ are different from each other. In the illustrated embodiment, the inner staple 4430 and the outer staple 4450 each have the same unformed height UFH. The inner and outer staples 4430, 4450 are formed from conventional surgical staple wires. In at least one embodiment, the diameter of the staple wire used to form the outer staple 4450 is larger than the diameter of the staple wire used to form the inner staple 4430. In one embodiment, the inner and outer staples may have the same diameter or may be formed from wires having other diameters. In some configurations, the inner and outer staples may be formed from the same type of staple wire. Thus, in such a configuration, the wire diameters of the inner and outer staples will be the same. However, in yet another embodiment, the inner and outer staples may have the same unformed shape / configuration but may be formed from two different staple wires having different wire diameters. Further, in at least one configuration, the crown width CW _O of each outer staple 4450 is greater than the crown width CW _I of each inner staple 4430. No. 14 / 319,008, filed Jun. 30, 2014, entitled "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS", filed Jun. 30, 2014, which is incorporated herein by reference in its entirety. U.S. Patent Application Publication No. 2015/0297232.

  Referring to FIG. 107, staple cartridge 4410 has an outer edge 4414 extending above deck surface 4412. During surgery, the physician can adjust the position of the anvil relative to the cartridge of the circular stapler. In at least one such embodiment, staple cartridge 4410 further includes deck features 4416 and 4418 extending from deck surface 4412. As can be seen in FIG. 107, a series of inner deck features 4416 includes an inner row 4420 of staple cavities 4422 and a centrally located knife opening 4413 through which the knife or cutting member passes during the firing process. Provided between The deck feature 4416 can be shaped as shown in FIGS. 107, 109 and 110 and positioned relative to the inner staple cavity and opening 4413. For example, each inner deck feature 4416 has a flat wall 4415 coextensive with the wall of the knife opening 4413 and a conical or beveled body portion 4417 adjacent a row of inner staple cavities 4422 You can have See FIG. 109 and FIG. In the embodiment shown in FIG. 107, the deck features 4416 are directed into the interstices between adjacent inner staple cavities 4422 and offset as shown between a pair of staple cavities 4422. The cavity extension configuration or deck feature of the system may serve to reduce the pressure normally experienced by flat deck cartridges. The configurations disclosed herein may also serve to reduce tissue migration and slippage. The outer diameter retention features may be larger or more numerous, as it is generally undesirable for tissue to slip. The inner diameter feature may play a role in increasing tissue tension / shear as the blade passes adjacently inside the inner diameter, which may allow for better cutting by the system. However, the deck features 4416 may have different shapes and configurations and may be located at different locations on the deck surface 4412.

  Also, as can be seen in FIGS. 107, 109 and 110, every other outer staple cavity 4442 includes outer deck features 4418 associated with each end of the cavity 4442. The outer deck feature 4418 extends above the deck surface 4412 and guides the outer staples 4450 towards the anvil as the staples 4450 are ejected from the staple cartridge 4410. In such embodiments, the outer staple 4450 may not project above the outer deck feature 4418 until it is moved toward the anvil by the firing member. Referring primarily to FIG. 107, in at least one embodiment, the outer deck feature 4418 does not extend around the entire corresponding outer staple cavity 4442. The first outer deck feature 4418 is positioned adjacent to the first end of the corresponding outer cavity 4442 and the second outer deck feature 4418 is adjacent to the second end of the outer cavity 4442 Be positioned. As can be seen in FIG. 107, the outer deck feature 4418 is associated with every other cavity of the outer staple cavity 4442. Such an arrangement can serve to reduce total pressure and minimize tissue stretch and movement. However, in other embodiments, the first and second outer deck features 4418 may be associated with each one of the outer staple cavities 4442. In still other embodiments, the outer deck features may extend around the entire circumference of the corresponding outer cavity. As can be seen in FIG. 109, the inner deck feature 4416 is shorter than the outer deck feature 4418. In other words, each inner deck feature projects above deck surface 4412 by a distance less than the distance each outer deck feature 4418 projects above deck surface 4412. Each outer deck feature may project above deck surface 4412 by the same distance that outer edge 4414 projects above deck surface 4412. In addition, as further seen in FIG. 109, each outer deck feature 4418 has a generally conical or tapered profile which inserts the stapler head into the patient's colon and rectum In the meantime, it can help to prevent tissue from getting caught in the deck features.

  The above described deck feature configurations can provide one or more advantages. For example, the upstanding outer edge may help to prevent tissue from sliding across the cartridge deck. This upstanding edge can also include a repeating pattern of peaks and valleys, rather than one continuous lip formation. The inner upright feature may also help to hold the tissue adjacent to the blade to provide an improved cut. The inner deck features may be between the cavities, or in an alternative configuration, the deck feature (s) may include one continuous upright lip. It may be desirable to balance the number of deck features in order to minimize the number of high energy (force) / compression zones while achieving the desired amount of tissue immobilization. Features concentric with the cavity may serve the additional purpose of minimizing tissue flow in the area where the staple legs project. Such an arrangement also facilitates forming the staple desirably when the staple legs are ejected and transferred to a receiving anvil pocket, which may consist of a corresponding forming pocket. Such localized pocket features increase the low compression zone while facilitating the cartridge supporting the legs as the staples exit the cartridge. Thus, this configuration minimizes the distance that the staple must "jump" before it contacts the anvil pocket. Tissue flow tends to increase radially outward from the center of the cartridge. Referring to FIG. 118, the improved lateral upright row extension stages tissue as the colon is a canal when the extension is inserted upwardly through the colon. Tend.

109 and 110 illustrate the use of a surgical staple cartridge 4410 in conjunction with anvil 4480. The anvil 4480 includes an anvil head portion 4482 operably supporting a staple forming insert or portion 4484 and a knife washer 4490. A knife washer 4490 is supported in face-to-face relationship with a knife 4492 supported within the stapler head. In the illustrated embodiment, staple forming inserts 4484 are made of, for example, steel, stainless steel, etc., and receive an inner row of inner staple forming pockets 4486 and an outer row of outer staple forming pockets 4488. Each inner staple forming pocket 4486 corresponds to one of the inner staple cavities 4422 and each outer staple forming pocket 4488 corresponds to one of the outer staple cavities 4442. In the illustrated configuration, the inner staple forming pocket 4486 is closer to the cartridge deck surface 4412 than the outer staple forming pocket 4488 when the anvil 4480 is moved relative to the cartridge deck surface 4412 to its firing position. In other words, the first gap _{g 1} or a first staple forming distance between the first staple forming portion 4485 and the cartridge deck surface 4412 between the second staple forming portion 4487 and the cartridge deck surface 4412 second gap g ₂ or less than a second staple forming distance.

As further seen in FIGS. 109 and 110, the inner staples 4430 are respectively supported in their corresponding inner staple cavities 4422 on corresponding inner driver portions 4502 of the pusher assembly 4500, and each of the outer staples 4450 are Supported within their corresponding outer staple cavities 4442 on corresponding outer driver portions 4504. As pusher assembly 4500 is advanced toward anvil 4480, inner and outer staples 4430, 4450 are driven into molded contact with their respective corresponding staple forming pockets 4486, 4488, as shown in FIG. Additionally, a knife 4492 penetrates the tissue clamped between the anvil 4480 and the deck surface 4412 and advances distally through the fragile bottom 4491 of the knife washer 4490. Such a configuration helps to provide the outer staple 4450 with a forming height FH _O that is greater than the forming height FH _I of the inner staple 4430. In other words, the outer rows 4440 of the outer staples 4450 are formed into a larger "B" shape and have a larger capture volume and / or higher staple formation to relieve high tissue compression near the outer staple rows 4440. Bring height. Larger B shapes may also improve blood flow towards the inner row. In various examples, the outer rows 4440 of the outer staples 4450 include greater resistance to deployment by utilizing larger staple crowns, staple leg widths, and / or staple leg thicknesses.

The amount of staples used in each staple row can vary. In one embodiment, for example, the number of outer staples 4450 is greater than the number of inner staples 4430. Another embodiment uses more inner staples 4430 than outer staples 4450. In various examples, the wire diameter of the outer staple 4450 is larger than the wire diameter of the inner staple 4430. The inner and outer staples 4430, 4450 may have the same unformed height UFH. The crown width CW _O in the outer row 4440 of the outer staples 4450 is greater than the crown width CW _I of the inner row 4420 of the inner staples 4430. The gull-wing structure of the outer staples 4450 uses bends located at different distances from their respective crowns. By using a stepped anvil structure with a flat (non-stepped) cartridge deck surface 4412 with uniform movement of the driver or pusher, staples of different formed heights are obtained.

  FIG. 111 illustrates another staple cartridge embodiment 4610. FIG. As seen in FIG. 111, staple cartridge 4610 includes a cartridge deck 4612 that includes an inner annular row 4620 of spaced apart inner staple cavities 4622 and an outer annular row 4640 of spaced apart outer staple cavities 4642. As can be seen in FIG. 111, the inner staple cavity 4622 is offset relative to the spaced apart outer staple cavity 4642. An inner surgical staple 4630 is supported within each inner staple cavity 4622 and an outer surgical staple 4650 is supported within each outer staple cavity 4642. In addition, the outer edge 4614 extends above the deck surface 4612. In various embodiments, in addition to the above, the staples 4630, 4650 do not project above the deck surface 4612 until the staples are moved toward the anvil by the firing member. Such embodiments often utilize small staples relative to the depth of their corresponding staple cavity in which the staples are stored. In one embodiment, the legs of the staples project above the deck surface 4612 when the staples are in their unfired position. In at least one such embodiment, staple cartridge 4610 further includes deck features 4616 and 4618 extending from deck surface 4612.

  Also, as can be seen in FIG. 111, every other inner staple cavity 4622 includes an inner deck feature 4616 associated with each end of the cavity 4622. The inner deck feature 4616 extends above the deck surface 4612 and guides the corresponding inner staple 4630 towards the anvil as the corresponding inner staple 4630 is ejected from the staple cartridge 4610. In such embodiments, the inner staple 4630 may not extend above the inner deck feature 4616 until it is moved towards the anvil by the firing member. In the illustrated example, the inner deck feature 4616 does not extend all around the corresponding inner staple cavity 4622. The first inner deck feature 4616 is positioned adjacent to the first end of the corresponding inner cavity 4622 and the second inner deck feature 4616 is adjacent to the second end of the inner cavity 4622 Be positioned. However, in one embodiment, the inner deck feature 4416 may be associated with each one of the inner staple cavities 4622. In still other embodiments, the inner deck feature may extend around the entire circumference of the corresponding inner staple cavity. By using deck features having different heights in a concentric pattern and associated with every other cavity, the pressure is balanced while wishing to guide as many staple legs as possible as long as possible Can provide more tissue clearance area. In other words, such a configuration can minimize tissue flow by reducing the overall amount of pressure applied to the target tissue.

  Still referring to FIG. 111, each outer staple cavity 4642 includes an outer deck feature 4618 associated with each end of the cavity 4642. The outer deck feature 4618 extends above the deck surface 4612 and guides the outer staples 4650 towards the anvil as the staples 4650 are ejected from the staple cartridge 4610. In such embodiments, the outer staple 4650 may not extend above the outer deck feature 4618 until it is moved toward the anvil by the firing member. As seen in FIG. 111, in the illustrated example, the outer deck feature 4618 does not extend around the entire periphery of the corresponding outer staple cavity 4642. A first outer deck feature 4618 is positioned adjacent to the first end of the corresponding outer cavity 4642 and a second outer deck feature 4618 is adjacent to the second end of the outer cavity 4642 Be positioned. As can be seen in FIG. 111, the outer deck feature 4618 is associated with each one of the outer staple cavities 4642. However, in other embodiments, the first and second outer deck features 4618 may be associated with every other outer staple cavity 4642. In still other embodiments, the outer deck features may extend around the entire circumference of the corresponding outer cavity. As can be seen in FIGS. 112 and 113, the inner deck feature 4616 and the outer deck feature 4618 extend the same distance above the deck surface 4612. Said another way, these features have the same height. In addition, as can be further appreciated from FIGS. 112 and 113, each inner deck feature 4416 and each outer deck feature 4618 have a generally conical or tapered profile, which profile is a staple head. It can help prevent tissue from getting stuck on the deck feature while being inserted into the patient's colon and rectum.

FIGS. 112 and 113 illustrate the use of a surgical staple cartridge 4610 in conjunction with anvil 4680. FIGS. Anvil 4680 includes an anvil head portion 4682 operably supporting a staple forming insert or portion 4684 and a knife washer 4690. A knife washer 4690 is supported in face-to-face relationship with a knife 4692 supported within the stapler head. In the illustrated embodiment, staple forming inserts 4684 are made of, for example, steel, stainless steel, etc. and receive the inner row of inner staple forming pockets 4686 and the outer row of outer staple forming pockets 4688. Each inner staple forming pocket 4686 corresponds to one of the inner staple cavities 4622 and each outer staple forming pocket 4688 corresponds to one of the outer staple cavities 4642. In the illustrated arrangement, the inner staple forming pockets 4686 are the outer staple forming pockets 4688 the same distance _{g 1} as located away from the deck surface 4612, located away from the deck surface 4612.

As further seen in FIGS. 112 and 113, inner staples 4630 are supported within corresponding inner staple cavities 4622 on corresponding inner driver portions 4702 of pusher assembly 4700. Outer staples 4650 are supported in corresponding outer staple cavities 4642 on corresponding outer driver portions 4704. As the pusher assembly 4700 is advanced towards the anvil 4680, the inner and outer staples 4630, 4650 are driven into molded contact with their respective corresponding staple forming pockets 4686, 4688 as shown in FIG. In addition, a knife 4692 penetrates the tissue clamped between the anvil 4680 and the deck surface 4612 and advances distally through the fragile bottom surface 4691 of the knife washer 4690. In the embodiment shown in FIG. 112 and FIG 113, the inner staple 4630 may be formed from a first first staple wire having a wire diameter D _1, having a first unformed height L _1. For example, a first wire diameter _{D 1} is approximately 0.0201Cm～0.038Cm (about 0.0079 "to 0.015") (increment normally, 0.0226cm, 0.0239cm, and 0.00368Cm (0 .0089 ′ ′, 0.0094 ′ ′, 0.00145 ′ ′)), and the first unformed height L ₁ is about 0.0079 ′ ′ to 0 (Increments are typically 0.0089 ′ ′, 0.0094 ′ ′, and 0.00145 ′ ′), and the first unformed height L ₁ is approximately 0.5029 cm-0 It may be .635 cm (0.198 "to 0.250"). Each outer staple 4650 may be formed from a second staple wire having a second wire diameter D _2, with a second unformed height L _2. In the embodiment shown in FIGS. 112 and 113, D ₁ <D ₂ and L ₁ <L ₂ . However, as can be seen in FIG. 113, the inner and outer staples 4630, 4650 are formed with the same forming height FH '. Outer thicker wire staples tend to provide higher tear strength and burst strength as compared to inner row smaller diameter staples that tend to maintain good hemostasis. In other words, a tighter inner row of staples can maintain good hemostasis, while a smaller row of staples with less compression can promote good healing and blood flow. In addition, the long staples of the leg can ensure a greater degree of B-shaped bending, even if formed at the same height as the short staples of the leg, this greater degree of The B-shape bend enhances the strength of the long leg staples and can increase the likelihood that the long leg staples will be properly formed sufficiently to hold under high load conditions. The amount of staples used in each staple row can vary. In one embodiment, for example, the inner row 4620 has the same number of inner staples 4630 as the outer row 4640 of the outer staples 4650 has. In various configurations, the crown width of the staples 4650 is greater than the crown width of the inner staples 4630. In one embodiment, the staples 4630, 4650 can have the same crown width. In other configurations, the staples 4630, 4650 may have the gull wing design described above. For example, at least one leg of the staple may include an inwardly curved end, or both legs may include an inwardly curved end towards each other. Such staples may be used in the inner annular row, or the outer annular row, or in both the inner and outer annular rows.

FIG. 114 illustrates another circular staple cartridge embodiment 4810 that includes a cartridge deck 4812 that includes three annular rows 4820, 4840, 4860 of spaced apart staple cavities. The inner or first row 4820 contains a first plurality of inner or first staple cavities 4822, each arranged at a first angle. Each inner staple cavity 4822 operatively supports a corresponding inner or first staple 4830 therein. The inner cavity 4822 directs the first staple 4830 at the same uniform angle with respect to the tangential direction. In the illustrated embodiment, each inner staple 4830 is formed from a first staple wire having a _first staple diameter D1. In one embodiment, the first staple wire diameter D ₁ is approximately 0.0201 cm to 0.038 cm (in increments typically 0.0226 cm, 0.0239 cm, and 0.00368 cm) (0.0079 "to 0.015 (Increments are typically 0.0089 ", 0.0094", and 0.00145 "). Referring to FIG. 117, each inner staple 4830 includes a first crown 4832 and two and a first leg 4834. the first crown have a first crown width C _1, the first leg 4834 includes first unformed leg length L ₁ In one embodiment, the first crown width C ₁ may be approximately 0.100 ′ ′ to 0.300 ′ ′, and the first unformed leg length L ₁ is approximately 0.503cm~0.635 m (0.100 "~0.300" and the first unformed cab length _{L 1} may be approximately 0.198 "to 0.250"). The first leg 4834, respectively, the for one of the staple crown 4832 may be disposed at an angle _{a 1.} angle _{a 1} may be about 90 °, or the angle _{a 1} is first its corresponding first staple 4830 It may be slightly larger than 90 ° so that the first leg 4834 is slightly flared outward to help hold it within the one staple cavity 4822.

  Referring now to FIGS. 115 and 116, staple cartridge 4810 is intended to be used with anvil 4900. Anvil 4900 includes two inner or first rows 4902 of offset or angled first pairs 4903 of first staple forming pockets 4904. Each first pair 4903 of the first staple forming pocket 4904 corresponds to one first staple 4830. One first staple forming pocket 4904 corresponds to one first staple leg 4834 and the other first staple forming pocket 4904 of the pair 4903 is in the other first staple leg 4834 It corresponds. In this configuration, one first leg 4834 is formed on one side of the first crown 4832 and the other first leg 4834 is formed on the other side of the first crown 4832 As such, the first staple leg 4834 of the first staple 4830 establishes the formed staple configuration formed out of plane with the first crown 4832 of this particular first staple 4830 To help. This “three-dimensional” formed staple configuration is shown in FIG. 115 for some of the first staple forming pockets 4904.

As best seen particularly in FIG. 116, cartridge deck 4812 has a "step-like" configuration. The cartridge deck 4812 includes an inner or first cartridge deck portion 4814 that corresponds to the inner or first annular row 4820 of the inner or first staple cavity 4822. As further seen in FIG. 116, the anvil 4900 is moved to the closed or clamping position, the anvil 4900, a portion containing a first staple forming pockets 4904 is separated from the deck portion 4814 by a first gap distance _{g 1} .

Referring again to FIGS. 114, 116 and 117, the middle or second row 4840 contains a second plurality of middle or second staple cavities 4842 positioned at a second angle, respectively. Each intermediate staple cavity 4842 operably supports a corresponding intermediate or second staple 4850 therein. The middle cavity 4842 directs the middle or second staple 4850 at the same uniform second angle with respect to the tangential direction. However, the second angle is different from the first angle. Stated differently, the axis of the first crown of each first staple 4830 when the first and second staples are supported within their corresponding first and second cavities. Will eventually intersect with the extended axis of the second crown of the adjacent second staple 4850. As can be seen in FIGS. 116 and 117, each second or intermediate staple 4850 includes a second staple crown or base 4852 and two second legs 4854. The staple base 4852 has a somewhat rectangular cross-sectional shape and can be formed from a flat sheet of material. The second staple leg 4854 can have, for example, a circular cross-sectional profile. No. 14 / 836,110, filed Aug. 26, 2015, entitled "SURGICAL STAPLING CONFIGURATIONS," for example, the second or intermediate staple, which is incorporated herein by reference in its entirety. It may include the various staple configurations disclosed in the FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS. By having a circular staple leg extending from the staple base portion having a rectangular cross-sectional profile, it is possible to provide a staple base portion and a staple leg that do not include a preferential bending plane. The second staple 4850 includes a bend 4856 where the staple leg 4854 extends from the staple base 4852. Bend 4856 may include a substantially square cross-sectional contour shape. The square and rectangular contours of the flexure 4856 and staple base 4852, respectively, provide a rigid connection and skeleton for the circular staple legs 4854. The circular staple legs 4854 eliminate preferential bending planes that may be possessed by staple legs having a square, rectangular, or any shape with apexes, or cross-sections with non-uniform shapes. Each of the second staple legs 4854, has a second diameter _{D 2.} In at least one embodiment, D ₂ > D ₁ . The second base or crown 4852 has a second crown width _{C 2.} In one configuration, C ₂ > C ₁ . The second leg 4854, respectively, may be arranged at an angle _{A 2} with respect to the second base or the crown 4852. Angle A ₂ may be about 90 °, or the angle A ₂ in order to assist in holding the second staple 4850 into the second staple cavity 4842 of its corresponding, second It may be slightly larger than 90 ° so that the legs 4854 can be spread slightly outward.

  Referring to FIGS. 115 and 116, anvil 4900 further includes two intermediate or second rows 4912 of offset or angled second pairs 4913 of second staple forming pockets 4914. Each second pair 4913 of second staple forming pockets 4914 corresponds to one second staple 4850. One second staple forming pocket 4914 corresponds to one second staple leg 4854 and the other second staple forming pocket 4914 of the pair 4913 is in the other second staple leg 4854. It corresponds. Such a configuration helps to establish a formed staple configuration in which the second leg 4854 is formed out of plane with the second base 4852 of a particular second staple 4850. This “three-dimensional” formed staple configuration is shown in FIG. 115 for some of the second staple forming pockets 4914.

As seen most particularly in FIG. 116, the cartridge deck 4812 further includes a second cartridge deck portion 4816 corresponding to the middle or second annular row 4840 of the middle or second staple cavities 4842. As further seen in FIG. 116, the anvil 4900 is moved to the closed or clamping position, the anvil 4900, the portion containing the second staple forming pockets 4914 is separated from the deck portion 4816 by a second gap distance _{g 2} . In the illustrated embodiment, g ₂ > g ₁ .

Referring again to FIGS. 114, 116 and 117, the outer or third row 4860 contains a third plurality of outer or third staple cavities 4862, which outer or third staple cavities 4862 Each outer or third staple cavity 4862 is dimensioned relative to the second staple cavity 4842 to span the distance between two adjacent second cavities 4842. Each outer staple cavity 4862 operatively supports a corresponding outer or third staple 4870 therein. The outer cavity 4862 directs the outer or third staple 4870 to a circumferential tangent. As can be seen in FIGS. 116 and 117, each third or outer staple 4870 includes a third staple crown or base 4872 and two third legs 4874. The staple base 4872 has a somewhat rectangular cross-sectional shape and can be formed from a flat sheet of material. The third staple leg 4874 can have, for example, a circular cross-sectional profile. No. 14 / 836,110, filed Aug. 26, 2015, entitled “SURGICAL STAPLING,” for example, the third or outer staple 4870 is incorporated herein by reference in its entirety. CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS "can be included. By having a circular staple leg extending from the staple base portion having a rectangular cross-sectional profile, it is possible to provide a staple base portion and a staple leg that do not include a preferential bending plane. The third staple 4870 includes a bend 4876 where the staple leg 4874 extends from the staple base 4872. Bend 4876 may include a substantially square cross-sectional contour shape. The square and rectangular contours of the flexures 4876 and staple base 4872, respectively, provide a rigid connection and skeleton for the circular staple legs 4874. The circular staple legs 4874 exclude preferential bending planes that may be possessed by staple legs having a square, rectangular, or any shape with apexes, or a cross section of non-uniform shape. In at least one embodiment, D ₃ > D ₂ . Third base or crown 4872 has a third crown width _{C 3,} each of the third leg 4874 includes a third unformed leg length _{L 3.} In one configuration, C ₃ > C ₂ and L ₃ > L ₂ . The third leg 4874, respectively, may be arranged at an angle _{A 3} relative to the third base or the crown 4872. Angle A ₃ may be about 90 °, or the angle A ₃ is to assist in retaining the third staple 4870 in the third staple cavity 4862 of its corresponding third It may be slightly larger than 90 ° so that the legs 4874 can be spread slightly outward.

Referring to FIGS. 115 and 116, the anvil 4900 further includes an outer row 4916 of outer or third staple forming pockets 4918. Each third staple forming pocket 4918 corresponds to one third staple 4870. As seen most particularly in FIG. 116, the cartridge deck 4812 further includes a third cartridge deck portion 4818 that corresponds to the outer or third row 4860 of the outer or third staple cavities 4862. As further seen in FIG. 116, the anvil 4900 is moved to the closed or clamping position, the anvil 4900, the portion containing the third staple forming pockets 4918 is separated from the deck portion 4818 by a third gap distance _{g 3} . In the illustrated embodiment, g ₃ > g ₂ . As further seen in FIG. 116, in at least one embodiment, a tissue thickness compensator 4920 is used with each outer or third staple 4870. The tissue thickness compensator may comprise a woven material incorporating oxidized regenerated cellulose (ORC) to promote hemostasis. Tissue thickness compensator 4920 is described in U.S. Patent Application No. 14 / 187,389, filed February 24, 2014, entitled "IMPLANTABLE LAYER ASSEMBLIES", U.S. Patent, the disclosure of which is incorporated herein by reference in its entirety. It may include any of the various tissue thickness compensator configurations disclosed in application publication 2015/0238187. As can be seen in FIG. 116, tissue thickness compensator 4920 has a thickness indicated as "a". In one embodiment, the tissue thickness compensator has a thickness of approximately 0.015 ′ ′ to 0.045 ′ ′. However, other thicknesses may be used.

  Furthermore, in at least one embodiment shown in FIGS. 114-117, staple cartridge 4810 can use a different number of staples in each of the three rows of staples. In one configuration, the inner staple row includes conventional staples having a minimum wire diameter and a shortest unformed leg length. Each first staple has the shortest crown width and each first staple is oriented at a uniform angle with respect to the tangential direction. The intermediate staple has a different configuration than the first staple configuration. Each leg of the intermediate staple includes medium wire diameter and unformed leg length. Each intermediate staple has a crown width slightly larger than the crown width of the inner staple. Each intermediate staple is oriented at a uniform angle with respect to the tangential direction but at a different angle with respect to the inner row of inner staples. Each outer staple has a configuration similar to that of the intermediate staples. Each third leg of each outer staple includes the largest wire diameter as compared to the wire diameter of the inner and middle staple legs. The crown width of each outer staple is significantly larger than the crown width of the inner and middle staples. Each outer staple is oriented tangentially in the circumferential direction of the cartridge. The outer staple row uses a woven tissue thickness compensator (spacer cloth) with an ORC incorporated to promote hemostasis. The stepped anvil and the stepped cartridge deck provide different formed staple heights, with the staple having the shortest forming height being in the inner row and the staple having the longest forming height being in the outer row . The anvil pockets corresponding to the inner and middle rows of staples are "tilted" to create three dimensional staples in the inner and middle rows. The "bathtub type" anvil pocket corresponds to the outer staple row. In at least one embodiment, the staples are fired continuously. For example, the staples in the inner and middle rows may be fired first, and the staples in the outer row may be fired thereafter. The annular knife cuts the clamped tissue during the firing process.

  As described in various embodiments of the present disclosure, a circular stapling instrument includes an anvil and a staple cartridge. One or both of the anvil and the staple cartridge are movable relative to one another between the open and closed configurations to capture tissue therebetween. The staple cartridge receives the staples within, or at least partially within, the circular array of staple cavities. The staples are deployed in circular rows from their corresponding staple cavities into the captured tissue and formed against the corresponding circular rows of forming pockets in the anvil. The firing drive is configured to cause the staples to be ejected from the staple cartridge during the firing stroke of the firing drive.

  The anvil of the circular stapling instrument generally includes a tissue compression surface and an annular array of staple forming pockets defined in the tissue compression surface. The anvil further includes a mounting mount and a stem extending from the mounting mount. The stem is configured to be removably attached to the closure drive of the circular stapling instrument such that the anvil can be moved towards and away from the staple cartridge of the circular stapling instrument .

  The staple cartridge and anvil can be moved separately within the patient's body and are combined in the surgical field. In various examples, for example, the staple cartridge travels through a thin tubular body of a patient, such as, for example, the colon. The staple cartridge can include, for example, a number of tissue contacting features such as a stepped deck and a pocket extender. The present disclosure, among other things, presents various changes to several tissue contact features to avoid causing unintended injury to the patient as the staple cartridge moves towards the target tissue.

  Referring to FIG. 118, a partial cross-sectional view shows that the staple cartridge 15500 of the circular surgical instrument is pressed against the tissue (T) as the staple cartridge 15500 moves within the patient's body. A number of structural features of staple cartridge 15500 have been modified to create an outer frame 15502 specifically contoured to protect tissue. Staple cartridge 15500 includes a plurality of annular staple row cavities. In at least one embodiment, as illustrated in FIG. 118, the outer row 15504 of staple cavities 15510 at least partially surround the inner row 15506 of staple cavities 15512. Staple cavities 15510 and 15512 are configured to receive staples 15530 and 15531, respectively.

  The terms inner and outer describe the relationship with respect to the central axis 15533. For example, the inner tissue contacting surface 15518 is closer to the central axis 15533 than the outer tissue contacting surface 15516.

  As illustrated in FIG. 119, staple cartridge 15500 includes a stepped cartridge deck 15508. The outer row 15504 is defined in the outer tissue contacting surface 15516 of the stepped cartridge deck 15508, while the inner row 15506 is defined in the inner tissue contacting surface 15518 of the stepped cartridge deck 15508. The outer tissue contacting surface 15516 steps down from the inner tissue contacting surface 15518, thereby forming a slope that reduces friction when the staple cartridge 15500 is pressed against the tissue.

  In some cases, the outer tissue contacting surface 15516 is parallel or at least substantially parallel to the inner tissue contacting surface 15518. In other cases, the outer tissue contacting surface 15516 is beveled such that a first plane defined by the outer tissue contacting surface 15516 traverses a second plane defined by the inner tissue contacting surface 15518 . A predetermined angle is defined between the first and second planes. The angle may be acute. In at least one case, the angle may be, for example, any angle selected from the range of greater than about 0 ° to about 30 ° or less. In at least one case, the angle may be, for example, any angle selected from the range of more than about 5 ° to about 25 ° or less. In at least one case, the angle may be, for example, any angle selected from the range of greater than about 10 ° to about 20 ° or less. The angled outer tissue contacting surface 15516 can reduce friction with or tissue clinging as the staple cartridge 15500 moves relative to the tissue. In at least one case, the angled outer tissue contacting surface 15516 is also stepped down from the inner tissue contacting surface 15518.

  In at least one case, the inner portion of the outer tissue contacting surface 15516 is planar or at least substantially planar, while the outer edge 15548 of the outer tissue contacting surface 15516 causes the staple cartridge 15500 to As it moves relative to it, it is beveled, arced and / or beveled to reduce friction with tissue or sticking of tissue. Staple cavities 15510 are, for example, in the planar inner portion of the outer tissue contacting surface 15516. The outer edge 15550 of the inner tissue contacting surface 15518 is also beveled, beveled to reduce friction with tissue or sticking of tissue as the staple cartridge 15500 moves relative to the tissue. And / or may be arc-shaped.

  The staple cavities 15510 of the outer row 15504 are pocket-expanded to accommodate staples having the same or at least substantially the same unformed height within the staple cavities 15510 of the outer row 15504 and the staple cavities 15512 of the inner row 15504 Part 15514 is included. The pocket extensions 15514 are configured to control and guide the staples 15530 as they are ejected from their corresponding staple cavities 15510. In some cases, the pocket extension 15514 can be configured, for example, to accommodate staples having a greater unformed height than the staples of the inner tissue contacting surface 15518.

  As illustrated in FIG. 119, the staple cavities 15510 of the outer row 15504 are laterally aligned or at least substantially aligned with the gap 15520 between two adjacent staple cavities 15512 in the inner row 15506. Staple cavity 15510 has a first end 15522 and a second end 15524. The second end 15524 overlaps the first end 15526 of one of two consecutive staple cavities 15512, thereby causing the staples to be located at the second end 15524 as illustrated in FIG. The legs 15530a radially align or at least substantially align with the staple legs 15531a located at the first end 15526. Similarly, a first end 15522 of staple cavity 15510 overlaps a second end 15528 of one of two consecutive staple cavities 15512.

  The pocket extension 15514 includes a first jacket 15532 projecting from the outer tissue contacting surface 15516 for hiding the tip 15536 of the staple leg 15530a extending beyond the outer tissue contacting surface 15516. The first jacket 15532 has an end 15538 projecting from the first end 15522 and an inner sidewall 15540 and an outer sidewall 15542 extending away from the end 15538 to form the first jacket 15532 Including. In at least one case, the first jacket 15532 defines, or at least substantially defines, a "C" shaped wall extending on a portion of the outer periphery 15535 of the staple cavity 15510 including the first end 15522 Do.

  The inner sidewall 15540 protrudes from the outer tissue contact surface 15516 to a higher height than the outer sidewall 15542 to reduce friction with tissue. In other words, the height of the outer side wall 15542 is lower than the inner side wall 15540. This configuration provides a smooth transition from the inner sidewall 15540, through the outer sidewall 15542, to the outer tissue contacting surface 15516. In at least one embodiment, the inner sidewall 15540 and the inner tissue contacting surface 15518 include the same or at least substantially the same height with respect to the outer tissue contacting surface 15516. Alternatively, the inner sidewall 15540 and the inner tissue contacting surface 15518 include different heights with respect to the outer tissue contacting surface 15516. In some cases, the height of the inner sidewall 15540 is lower than the inner tissue contacting surface 15518 relative to the outer tissue contacting surface 15516. This configuration provides a smooth transition from the inner tissue contacting surface 15518, through the inner sidewall 15540, through the outer sidewall 15542, to the outer tissue contacting surface 15516.

  The inner tissue contacting surface 15518, the inner sidewall 15540, the outer sidewall 15542, and / or the outer tissue contacting surface 15516 define distinct portions of the contoured outer frame 15502. Nevertheless, as illustrated in FIG. 118, such portions are sufficiently close to one another that tissue can not be trapped between the portions when the staple cartridge 15500 is pressed against the tissue. It is supposed to be. Additionally, one or more of the portions may include a beveled, contoured, curved, arced, and / or beveled outer surface to reduce friction with tissue. As illustrated in FIG. 118, the upper surface 15544 of the outer sidewall 15542 and the upper surface 15546 of the inner sidewall 15540 are beveled, contoured, curved, rounded to define the contoured outer frame 15502. Arced and / or beveled.

  In at least one case, upper surface 15544 and upper surface 15546 define a sloped plane transverse to a first plane defined by outer tissue contacting surface 15516 and a second plane defined by inner tissue contacting surface 15518. In at least one case, a first angle is defined between the inclined plane and the first plane. A second angle may also be defined between the inclined plane and the second plane. The first angle value and the second angle value may be the same or at least substantially the same. Alternatively, the value of the first angle may be different from the value of the second angle. In at least one case, the first angle and / or the second angle is an acute angle. In at least one case, the first angle is, for example, any angle selected from the range of more than about 0 ° to about 30 ° or less. In at least one case, the first angle is, for example, any angle selected from the range of more than about 5 ° to about 25 ° or less. In at least one case, the first angle is, for example, any angle selected from the range of more than about 10 ° to about 20 ° or less. In at least one case, the second angle is, for example, any angle selected from the range of more than about 0 ° to about 30 ° or less. In at least one case, the second angle is, for example, any angle selected from the range of more than about 5 ° to about 25 ° or less. In at least one case, the second angle is, for example, any angle selected from the range of more than about 10 ° to about 20 ° or less.

  In addition to the above, the pocket extension 15514 includes a second jacket 15534 that is similar to the first jacket 15532 in many respects. Similar to the first jacket 15532, a second jacket 15534 projects from the outer tissue contacting surface 15516 to hide the tips of the staple legs extending beyond the outer tissue contacting surface 15516. The second jacket 15534 includes an end 15538 projecting from the second end 15524 and an inner sidewall 15540 and an outer sidewall 15542 extending from the end 15538 to form a second jacket 15534.

  While one pocket extension 15514 is illustrated in FIG. 119, it is understood that, for example, one or more other pocket extensions 15514 may protrude from the outer tissue contacting surface 15516. In at least one case, the first jacket 15532 and the second jacket 15534 are connected by a sidewall, for example, to define a pocket extension that completely encloses the staple cavity.

  Although many of the surgical instrument systems described herein are operated by electric motors, the surgical instrument systems described herein can operate in any suitable manner. In various cases, the surgical instrument system described herein can operate, for example, with a manually operated trigger. In some cases, the motor disclosed herein may include a portion of a robotic control system. Additionally, any of the end effector and / or tool assemblies disclosed herein can be utilized with a robotic surgical instrument system. FIG. 82A schematically illustrates a robotic surgical instrument system 20 '. However, U.S. patent application Ser. No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENT", currently U.S. Patent Application Publication No. 2012/0298719, is directed to some of the robotic surgical instrument systems, for example. The examples are disclosed in more detail.

  Although the surgical instrument system described herein is described in connection with deployment and deformation of staples, the embodiments described herein are not limited thereto. Various embodiments are also envisioned that deploy fasteners other than staples, such as clamps or tacks. Furthermore, various embodiments are also contemplated that utilize any suitable means for sealing tissue. For example, an end effector according to various embodiments may include an electrode configured to heat and seal tissue. Also for example, end effectors according to certain embodiments can apply vibrational energy to seal tissue.

The following disclosure is incorporated herein by reference in its entirety.
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  Although various devices have been described herein with particular embodiments, modifications and variations may be implemented to those embodiments. Also, although materials are disclosed for specific components, other materials may be used. Further, in accordance with various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function. . The above description and the following claims are intended to cover all such modifications and variations.

  The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. However, in each case, the device may be reconditioned for reuse after at least one use. Reconditioning may include any combination of steps such as, but not limited to, disassembly of the device, subsequent cleaning or replacement of certain parts of the device, and subsequent reassembly of the device. it can. Specifically, after the reconditioning facility and / or the surgical team disassembles the device, certain parts of the device can be cleaned and / or replaced, and the device can be reassembled for later use. Those skilled in the art will appreciate that reconditioning of the device can utilize various techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present invention.

  The devices disclosed herein may be processed prior to surgery. Initially, new or used equipment may be obtained and cleaned as needed. The device can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag or TYVEK bag. The container and instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, x-rays, and / or high energy electrons. Radiation can kill bacteria on the instrument and in the container. The sterilized device can then be stored in the sterile container. The sealed container can keep the device sterile until it is opened at the medical facility. The device may also be sterilized using any other technique known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, hydrogen peroxide plasma, or water vapor.

  Although the invention has been described as having a representative design, the invention may be further modified within the spirit and scope of the present disclosure. Accordingly, the present application is intended to cover any variations, uses, or adaptations of the present invention that use its general principles.

  All patents, publications, or other disclosures incorporated herein, in whole or in part, in their existing definitions, descriptions, or other disclosures, are incorporated by reference into this disclosure. It shall be incorporated herein only to the extent not inconsistent with the contents. As such, and to the extent necessary, the disclosure content as explicitly set forth herein supersedes any conflicting description incorporated herein by reference. Any documents, or portions thereof that conflict with the existing definitions, descriptions, or other disclosed documents described herein, which are incorporated herein by reference, will be incorporated from the incorporated documents and existing documents. It shall be incorporated only to the extent that no contradiction arises with the disclosed contents.

[Aspect of embodiment]
(1) an end effector for use with a surgical stapler,
A cartridge body including a longitudinal axis;
A plurality of staple cavities defined in the cartridge body,
A first staple cavity annular array extending around the longitudinal axis;
A plurality of staple cavities including a second annular array of staple cavities extending about the longitudinal axis;
Staples removably stored in the staple cavity;
An inclined surface rotatable about said longitudinal axis along a helical firing path to eject said staples from said staple cavity.
(2) The apparatus according to embodiment 1, further including a staple driver, wherein the inclined surface is configured to be in continuous engagement with the staple driver to cause the staples to be ejected continuously from the staple cavity. Description end effector.
(3) The inclined surface continuously ejects the staples stored in the first staple cavity row before continuously ejecting the staples stored in the second staple cavity row The end effector according to claim 2, wherein
(4) The cartridge body includes a helical slot configured to guide the inclined surface, the helical slot being about the longitudinal axis, with constant access to the longitudinal axis. The end effector of embodiment 1 extending.
(5) The cartridge body includes a helical slot configured to guide the inclined surface, and the helical slot extends around the longitudinal axis, constantly away from the longitudinal axis. The end effector of claim 1, wherein the end effector is present.

(6) The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis while approaching the longitudinal axis The end effector according to any one of the preceding claims.
(7) The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis The end effector according to any one of the preceding claims.
(8) The staple is
A plurality of first staples, each said first staple being positioned within said first staple cavity annular row, each said first staple being defined by a first unformed height And several first staples,
A plurality of second staples, each of the second staples being positioned within the second row of staple cavity annular rows, each of the second staples being different from the first unformed height; The end effector of claim 1, comprising a plurality of second staples defined by an unformed height of
(9) further comprising an anvil configured to deform the staple, wherein the anvil deforms the first staple to a first formed height and forms the second staple as a second The end effector according to claim 8, configured to deform in height, wherein the first formed height is different from the second formed height.
(10) An end effector of a surgical stapler,
A cartridge body including a longitudinal axis;
A plurality of staple cavities defined in the cartridge body;
Staples removably stored in the staple cavity;
An emitting member rotatable about said longitudinal axis for causing said staples to be ejected continuously from said staple cavity.

Embodiment 11: The embodiment 10 further including a staple driver, wherein the firing member is configured to be in continuous engagement with the staple driver to cause the staples to be ejected continuously from the staple cavity. Description end effector.
(12) The plurality of staple cavities are
A first staple cavity annular array extending around the longitudinal axis;
A second annular row of staple cavities extending about the longitudinal axis, the firing member prior to sequentially firing the staples stored in the second row of staple cavities; 11. The end effector of embodiment 10, wherein the staples stored in the first row of staple cavities are ejected continuously.
(13) The cartridge body includes a helical slot configured to guide the firing member, the helical slot being about the longitudinal axis, with constant access to the longitudinal axis. The end effector of embodiment 10, wherein the end effector is extended.
(14) The cartridge body includes a helical slot configured to guide the firing member, the helical slot extending around the longitudinal axis, constantly away from the longitudinal axis The end effector of claim 10, wherein:
(15) The cartridge body includes a curved slot configured to receive the firing member, wherein the curved slot extends around the longitudinal axis while approaching the longitudinal axis The end effector according to claim 10, wherein:

(16) The cartridge body includes a curved slot configured to receive the firing member, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis The end effector according to claim 10, wherein:
(17) The staple is
A plurality of first staples, each said first staple being positioned within said first staple cavity annular row, each said first staple being defined by a first unformed height And several first staples,
A plurality of second staples, each of the second staples being positioned within the second row of staple cavity annular rows, each of the second staples being different from the first unformed height; The end effector according to claim 12, comprising a plurality of second staples defined by an unformed height of
(18) further comprising an anvil configured to deform the staple, wherein the anvil deforms the first staple to a first formed height and forms the second staple as a second 18. The end effector of embodiment 17 configured to deform to a height, wherein the first formed height is different than the second formed height.
(19) An end effector for use with a surgical stapler configured to apply an annular array of staples, the end effector comprising:
With the cartridge body,
A plurality of staple cavities defined in the cartridge body,
A first staple cavity annular array,
A plurality of staple cavities, including a second staple cavity annular array;
A first group of staples removably stored in the first annular row of staple cavities;
A second group of staples removably stored in the second annular row of staple cavities;
A plurality of staple drivers, each staple driver being configured to eject the staples from the staple cavity;
A drive slot defined along an arcuate path, the arcuate path being a first portion of the first staple cavity annular row extending downwardly, and a second staple cavity annular row A drive slot including a downwardly extending trailing portion;
An angled surface slidable within the drive slot, the angled surface being configured to engage the staple driver to cause the staples to be ejected from the staple cavity; Including, end effectors.

Claims (19)

An end effector for use with a surgical stapler;
A cartridge body including a longitudinal axis;
A plurality of staple cavities defined in the cartridge body,
A first staple cavity annular array extending around the longitudinal axis;
A plurality of staple cavities including a second annular array of staple cavities extending about the longitudinal axis;
Staples removably stored in the staple cavity;
An inclined surface rotatable about said longitudinal axis along a helical firing path to eject said staples from said staple cavity.   The end according to claim 1, further comprising a staple driver, wherein the beveled surface is configured to continuously engage the staple driver to cause the staples to be ejected continuously from the staple cavity. Effector.   The inclined surface continuously ejects the staples stored in the first row of staple cavities before continuously ejecting the staples stored in the second row of staple cavities. The end effector according to Item 2.   The cartridge body includes a helical slot configured to guide the inclined surface, the helical slot extending around the longitudinal axis with constant access to the longitudinal axis The end effector according to claim 1.   The cartridge body includes a helical slot configured to guide the inclined surface, the helical slot extending around the longitudinal axis, constantly away from the longitudinal axis The end effector of claim 1.   The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis while approaching the longitudinal axis. The end effector according to claim 1.   The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis. The end effector according to claim 1. The staple is
A plurality of first staples, each said first staple being positioned within said first staple cavity annular row, each said first staple being defined by a first unformed height And several first staples,
A plurality of second staples, each of the second staples being positioned within the second row of staple cavity annular rows, each of the second staples being different from the first unformed height; The end effector of claim 1, comprising: a plurality of second staples defined by an unformed height of:   The apparatus further includes an anvil configured to deform the staple, the anvil deforms the first staple to a first formed height and the second staple to a second formed height. 9. The end effector of claim 8, configured to deform, wherein the first formed height is different than the second formed height. An end effector of a surgical stapler,
A cartridge body including a longitudinal axis;
A plurality of staple cavities defined in the cartridge body;
Staples removably stored in the staple cavity;
An emitting member rotatable about said longitudinal axis for causing said staples to be ejected continuously from said staple cavity.   11. The end according to claim 10, further comprising a staple driver, wherein the firing member is configured to continuously engage the staple driver to cause the staples to be ejected continuously from the staple cavity. Effector. The plurality of staple cavities are
A first staple cavity annular array extending around the longitudinal axis;
A second annular row of staple cavities extending about the longitudinal axis, the firing member prior to sequentially firing the staples stored in the second row of staple cavities; 11. The end effector according to claim 10, wherein the staples stored in the first row of staple cavities are ejected continuously.   The cartridge body includes a helical slot configured to guide the firing member, the helical slot extending around the longitudinal axis with constant access to the longitudinal axis The end effector according to claim 10.   The cartridge body includes a helical slot configured to guide the firing member, the helical slot extending around the longitudinal axis, constantly away from the longitudinal axis The end effector of claim 10.   The cartridge body includes a curved slot configured to receive the firing member, the curved slot extending around the longitudinal axis while approaching the longitudinal axis. The end effector according to claim 10.   The cartridge body includes a curved slot configured to receive the firing member, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis. The end effector according to claim 10. The staple is
A plurality of first staples, each said first staple being positioned within said first staple cavity annular row, each said first staple being defined by a first unformed height And several first staples,
A plurality of second staples, each of the second staples being positioned within the second row of staple cavity annular rows, each of the second staples being different from the first unformed height; 13. The end effector of claim 12, comprising a plurality of second staples defined by an unformed height of.   The apparatus further includes an anvil configured to deform the staple, the anvil deforms the first staple to a first formed height and the second staple to a second formed height. 18. The end effector of claim 17, configured to be deformed, wherein the first formed height is different than the second formed height. An end effector for use with a surgical stapler configured to apply an annular array of staples, the end effector comprising:
With the cartridge body,
A plurality of staple cavities defined in the cartridge body,
A first staple cavity annular array,
A plurality of staple cavities, including a second staple cavity annular array;
A first group of staples removably stored in the first annular row of staple cavities;
A second group of staples removably stored in the second annular row of staple cavities;
A plurality of staple drivers, each staple driver being configured to eject the staples from the staple cavity;
A drive slot defined along an arcuate path, the arcuate path being a first portion of the first staple cavity annular row extending downwardly, and a second staple cavity annular row A drive slot including a downwardly extending trailing portion;
An angled surface slidable within the drive slot, the angled surface being configured to engage the staple driver to cause the staples to be ejected from the staple cavity; Including, end effectors.

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